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"consultation_id": "day1_consultation01",
"dialogue": "[Doctor] Hello? Hi. Um, should we start? Yeah, okay. Hello how um. Good morning sir, how can I help you this morning?\n[Patient] Hello, how are you?\n[Patient] Oh hey, um, I've just had some diarrhea for the last three days, um, and it's been affecting me I need to stay close to the toilet. And, um, yeah, it's been affecting my day-to-day activities.\n[Doctor] Sorry to hear that. Um, and and when you say diarrhea, what'd you mean by diarrhea? Do you mean you're going to the toilet more often? Or are your stools more loose?\n[Patient] Yeah, so it's like loose and watery stool, going to the toilet quite often, uh and like some pain in my, like, lower stomach?\n[Doctor] \n[Doctor] Okay. And how many times a day are you going, let's say, in the last couple of days?\n[Patient] Um, probably like six or seven times a day? Yeah.\n[Doctor] Six, seven times a day. And you mention it's mainly watery. Have you noticed any other things, like blood in your stools?\n[Patient] No, no blood, yeah, just watery and loose stool.\n[Doctor] Okay. And you mentioned you've had some pain in your tummy as well. Whereabouts is the pain, exactly?\n[Patient] Yep. So in my lower abdomen, so, uh, like, um...yeah, just to one side.\n[Doctor] One side. And what side is that?\n[Patient] Uh, on the left side.\n[Doctor] Left side. Okay, and can you describe the pain to me?\n[Patient] Yeah, it feels, um, like a cramp, like a muscular cramp, and, um, yeah i feel a bit uh weak and shaky.\n[Doctor] Okay. And is the pain, is that, is it there all the time, or does it come and go?\n[Patient] Uh, it comes and goes.\n[Doctor] Come and go. Does the pain move anywhere else, for example towards your back?\n[Patient] Uh...no, just maybe my stomach.\n[Doctor] Okay, fine. And you mentioned you've been feeling quite weak and shaky as well. What do you mean by shaky? Do you mean you've been having, uh have you been feeling feverish, for example?\n[Patient] Yeah.\n[Patient] Um, yeah, it doesn't feel like -- yeah, it just makes me feel weak. I haven't had a fever, um, at the moment, but I did notice um a temperature when the symptoms started, so, um, yeah around about three or four days ago.\n[Doctor] \n[Doctor] You measure your temperature then?\n[Patient] Yeah, I uh I didn't mention my temperature, no, but I felt, um, just a bit hot. And, y'know.\n[Doctor] Okay. Okay. Any other symptoms like sweating, or um, night sweats? No? And, uh, any vomiting at all?\n[Patient] Uh, no.\n[Patient] Yeah, so um, I vomited at the start of the symptoms but now um I've stopped vomiting.\n[Doctor] You stopped vomiting, okay. And was your vomit, I know it's not a nice thing to talk about, but was it just normal food colour Yeah. And there was no blood in your vomit, is that right?\n[Patient] Yeah, yeah, just normal vomit, yeah. No no blood, no. Yeah.\n[Doctor] No, okay. Um, and um, any any other symptoms at all? So you mentioned tummy pain, you mentioned diarrhea, you mentioned your vomiting, uh, anything else that comes to mind?\n[Patient] Yep. Um, I had a loss of appetite, um, so I haven't been eating as much, but I've been able to hold down fluids.\n[Doctor] Okay.\n[Doctor] Okay, so you're drinking fluids. Um, what kind of foods have you managed to eat, if anything?\n[Patient] Yep.\n[Patient] Um, just soups, and, uh, yeah, light foods. Like smoothies and, yeah, liquid foods mainly.\n[Doctor] Okay. Fine. Um, and sir these started three days ago the symptoms. Are you aware of any triggers which may have caused the symptoms uh to kick on. So for example, think like takeaway foods or eating out or being around other people with similar symptoms.\n[Patient] \n[Patient] Yeah, so I had takeaway about four days ago, um, uh, but other than that I've, yeah, been, uh, eating normally. Nothing unusual here.\n[Doctor] Okay. Do you remember where you ate?\n[Patient] Um, yeah, I ate at a Chinese restaurant with friends. Yeah.\n[Doctor] Okay. Anyone else unwell with similar symptoms?\n[Patient] Um, so no one else in the family, so a wife and two kids and one, um, child was vomiting, but they haven't got diarrhea. There's no one with the same symptoms.\n[Doctor] Okay, okay. Fine. Um, alright. And uh, in terms of your , your overall health, are you normally fit and well? Or, uh\n[Patient] Um, yeah, I mean, other than um athsma, um I use an inhaler, everything uh else is fine.\n[Doctor] Okay. And, is your asthma well-controlled?\n[Patient] Uh, yeah, that's fine. I just, yeah, use an inhaler, and uh that's under control.\n[Doctor] Fine. And you don't have any other tummy problem, bowel problems I should be aware of?\n[Patient] No.\n[Doctor] No, okay. Um, and apart from the inhalers, do you take any other medications?\n[Patient] Uh, no, no other medications.\n[Doctor] Okay, fine. And in terms of just your day to day life, you said it's been affecting your life, um, in what way has it been affecting your life?\n[Patient] Yeah.\n[Patient] Uh, so, I need to stay close to the toilet 'cause I go quite frequently during the these past three days. Um, yeah, other than that, it's uh, yeah, the main concern.\n[Doctor] Okay.\n[Doctor] Yeah. And have you, are you currently working at the moment? \n[Patient] Uh, yes, yeah. I I work, er. Um, I'm an accountant.\n[Doctor] Would, would work.\n[Doctor] Okay. Have you been going into work the last three days, or have you been at home?\n[Patient] Uh, yeah, I've been going to work. Yeah. Yeah, it's been quite difficult.\n[Doctor] okay. That must be difficult for you then. fine. And you said, you mentioned you live with your wife and two children, is that right?\n[Patient] Yes, yeah.\n[Doctor] Right, alright. Um, just a couple of other question we need to ask, sir. Um, do you smoke at all?\n[Patient] Uh, no, I don't smoke.\n[Doctor] And do you drink much in the way of alcohol?\n[Patient] Uh, no, I I don't drink alcohol, no. \n[Doctor] Okay. so um, er normally at this stage I like to um, examine you if that's okay, but um, um, but but having listened to your story, sir, I think uh, um, just to recap for the last three days you've been having loose stool, diarrhea, a bit of tummy pain uh mainly on the left-hand side, um and vomiting and fever and you're quite weak and lethargic um, you mentioned you had this Chinese takeaway as little as three days ago and I wondered whether that might be the cause of your problems.\n[Patient] Yeah.\n[Patient] \n[Patient] Okay.\n[Doctor] Um, it seems like you may have something, uh, called gastroenteritis, which essentially just a tummy bug or infection of your uh of your tummy.\n[Patient] \n[Doctor] Uh, mainly caused by viruses but there can be a possibility of bacteria uh causing its symptoms. Um.\n[Patient] Yeah.\n[Patient] Yeah.\n[Doctor] At this stage, uh, what, what we'd recommend is just what we say conservative management. So, um, I don't think you need anything like antibiotics. It's really just, um, making sure you're well hydrated, so drinking fluids.\n[Patient] \n[Patient] Mm-hmm.\n[Doctor] Um, there are things like Dioralyte you can get from the pharmacy, which uh it's um it helps helps replenish your minerals and vitamins.\n[Patient] Okay.\n[Doctor] Um, and if you are having vomiting diarrhea I would say recommend that in the first, you know, first couple of days.\n[Patient] Yep.\n[Doctor] If you are feeling feverish and weak, eh taking some paracetamol, uh, two tablets up to four times a day for the first few days can also help.\n[Patient] Yep.\n[Doctor] I will certainly advise you to take some time off work, actually I know you're quite keen to work but I would say the next two, two to three days as the infection clears from your system to take some time off and rest.\n[Patient] Okay.\n[Patient] Yeah.\n[Doctor] Um, I'll admit if your symptoms haven't got better, you know, in in three to four days, I'd like to come and see you again. \n[Patient] Okay, sure.\n[Doctor] Because if it is ongoing then we have to wonder whether something else caused your symptoms.\n[Patient] Yep.\n[Doctor] Uh, and we may need to do further tests like um taking a sample of your stool so we can test that.\n[Patient] \n[Doctor] Um, etcetera etcetera.\n[Patient] Yep, sure, yep.\n[Doctor] How's that sound?\n[Patient] That sounds great, yeah. Yeah.\n[Doctor] Do you have any questions for me?\n[Patient] Um, no, no further questions, no.\n[Doctor] Okay, and is uh is the treatment plan clear?\n[Patient] Uh, yes, yeah, that's that's very clear. Thank you.\n[Doctor] Great. Well, I wish you all the best.\n[Patient] Okay, thank you. Bye.\n[Doctor] Thank you. Bye bye.",
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"text": "Hello? Hi. Um, should we start? Yeah, okay. Hello how um. Good morning sir, how can I help you this morning?",
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"text": "Hello, how are you?",
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"text": "Oh hey, um, I've just had some diarrhea for the last three days, um, and it's been affecting me I need to stay close to the toilet. And, um, yeah, it's been affecting my day-to-day activities.",
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"text": " Sorry to hear that. Um, and and when you say diarrhea, what'd you mean by diarrhea? Do you mean you're going to the toilet more often? Or are your stools more loose?",
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"text": "Yeah, so it's like loose and watery stool, going to the toilet quite often, uh and like some pain in my, like, lower stomach?",
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"text": "Okay. And how many times a day are you going, let's say, in the last couple of days?",
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"text": "Um, probably like six or seven times a day? Yeah.",
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"text": "Six, seven times a day. And you mention it's mainly watery. Have you noticed any other things, like blood in your stools?",
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"text": "No, no blood, yeah, just watery and loose stool.",
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"text": "Okay. And you mentioned you've had some pain in your tummy as well. Whereabouts is the pain, exactly?",
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"text": "Yep. So in my lower abdomen, so, uh, like, um...yeah, just to one side.",
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"text": "One side. And what side is that?",
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"text": "Uh, on the left side.",
"speaker": "Patient"
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"text": "Left side. Okay, and can you describe the pain to me?",
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"text": "Yeah, it feels, um, like a cramp, like a muscular cramp, and, um, yeah i feel a bit uh weak and shaky.",
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"text": "Okay. And is the pain, is that, is it there all the time, or does it come and go?",
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"text": "Uh, it comes and goes.",
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"text": "Come and go. Does the pain move anywhere else, for example towards your back?",
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"text": "Uh...no, just maybe my stomach.",
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"text": "Okay, fine. And you mentioned you've been feeling quite weak and shaky as well. What do you mean by shaky? Do you mean you've been having, uh have you been feeling feverish, for example?",
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"text": "Um, yeah, it doesn't feel like -- yeah, it just makes me feel weak. I haven't had a fever, um, at the moment, but I did notice um a temperature when the symptoms started, so, um, yeah around about three or four days ago.",
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"text": "You measure your temperature then?",
"speaker": "Doctor"
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"text": "Yeah, I uh I didn't mention my temperature, no, but I felt, um, just a bit hot. And, y'know.",
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"text": "Okay. Okay. Any other symptoms like sweating, or um, night sweats? No? And, uh, any vomiting at all?",
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"text": "Uh, no.",
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"text": "Yeah, so um, I vomited at the start of the symptoms but now um I've stopped vomiting.",
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"text": "You stopped vomiting, okay. And was your vomit, I know it's not a nice thing to talk about, but was it just normal food colour Yeah. And there was no blood in your vomit, is that right?",
"speaker": "Doctor"
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"text": "Yeah, yeah, just normal vomit, yeah. No no blood, no. Yeah.",
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"text": "No, okay. Um, and um, any any other symptoms at all? So you mentioned tummy pain, you mentioned diarrhea, you mentioned your vomiting, uh, anything else that comes to mind?",
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"text": "Yep. Um, I had a loss of appetite, um, so I haven't been eating as much, but I've been able to hold down fluids.",
"speaker": "Patient"
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"text": " Okay.",
"speaker": "Doctor"
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"text": "Okay, so you're drinking fluids. Um, what kind of foods have you managed to eat, if anything?",
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"text": "Yep.",
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"text": "Um, just soups, and, uh, yeah, light foods. Like smoothies and, yeah, liquid foods mainly.",
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"text": "Okay. Fine. Um, and sir these started three days ago the symptoms. Are you aware of any triggers which may have caused the symptoms uh to kick on. So for example, think like takeaway foods or eating out or being around other people with similar symptoms.",
"speaker": "Doctor"
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"text": "Yeah, so I had takeaway about four days ago, um, uh, but other than that I've, yeah, been, uh, eating normally. Nothing unusual here.",
"speaker": "Patient"
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"text": "Okay. Do you remember where you ate?",
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"text": "Um, yeah, I ate at a Chinese restaurant with friends. Yeah.",
"speaker": "Patient"
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"text": "Okay. Anyone else unwell with similar symptoms?",
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"text": "Um, so no one else in the family, so a wife and two kids and one, um, child was vomiting, but they haven't got diarrhea. There's no one with the same symptoms.",
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"text": "Okay, okay. Fine. Um, alright. And uh, in terms of your , your overall health, are you normally fit and well? Or, uh",
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"text": "Um, yeah, I mean, other than um athsma, um I use an inhaler, everything uh else is fine.",
"speaker": "Patient"
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"text": "Okay. And, is your asthma well-controlled?",
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"text": "Uh, yeah, that's fine. I just, yeah, use an inhaler, and uh that's under control.",
"speaker": "Patient"
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"text": "Fine. And you don't have any other tummy problem, bowel problems I should be aware of?",
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"text": "No.",
"speaker": "Patient"
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"text": "No, okay. Um, and apart from the inhalers, do you take any other medications?",
"speaker": "Doctor"
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"text": "Uh, no, no other medications.",
"speaker": "Patient"
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"text": "Okay, fine. And in terms of just your day to day life, you said it's been affecting your life, um, in what way has it been affecting your life?",
"speaker": "Doctor"
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"text": "Yeah.",
"speaker": "Patient"
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"text": "Uh, so, I need to stay close to the toilet 'cause I go quite frequently during the these past three days. Um, yeah, other than that, it's uh, yeah, the main concern.",
"speaker": "Patient"
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"text": "Okay.",
"speaker": "Doctor"
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"text": "Yeah. And have you, are you currently working at the moment? ",
"speaker": "Doctor"
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"text": "Uh, yes, yeah. I I work, er. Um, I'm an accountant.",
"speaker": "Patient"
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"text": "Would, would work.",
"speaker": "Doctor"
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"text": "Okay. Have you been going into work the last three days, or have you been at home?",
"speaker": "Doctor"
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"text": "Uh, yeah, I've been going to work. Yeah. Yeah, it's been quite difficult.",
"speaker": "Patient"
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"text": " okay. That must be difficult for you then. fine. And you said, you mentioned you live with your wife and two children, is that right?",
"speaker": "Doctor"
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"text": "Yes, yeah.",
"speaker": "Patient"
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"text": "Right, alright. Um, just a couple of other question we need to ask, sir. Um, do you smoke at all?",
"speaker": "Doctor"
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"text": "Uh, no, I don't smoke.",
"speaker": "Patient"
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"text": "And do you drink much in the way of alcohol?",
"speaker": "Doctor"
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"text": "Uh, no, I I don't drink alcohol, no. ",
"speaker": "Patient"
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"text": "Okay. so um, er normally at this stage I like to um, examine you if that's okay, but um, um, but but having listened to your story, sir, I think uh, um, just to recap for the last three days you've been having loose stool, diarrhea, a bit of tummy pain uh mainly on the left-hand side, um and vomiting and fever and you're quite weak and lethargic um, you mentioned you had this Chinese takeaway as little as three days ago and I wondered whether that might be the cause of your problems.",
"speaker": "Doctor"
},
{
"start": 330.07645,
"end": 331.07645,
"text": "Yeah.",
"speaker": "Patient"
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"speaker": "Patient"
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"text": "Okay.",
"speaker": "Patient"
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"text": "Um, it seems like you may have something, uh, called gastroenteritis, which essentially just a tummy bug or infection of your uh of your tummy.",
"speaker": "Doctor"
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"text": "",
"speaker": "Patient"
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{
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"text": "Uh, mainly caused by viruses but there can be a possibility of bacteria uh causing its symptoms. Um.",
"speaker": "Doctor"
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{
"start": 358.66452,
"end": 359.66452,
"text": "Yeah.",
"speaker": "Patient"
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{
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"end": 367.70368,
"text": "Yeah.",
"speaker": "Patient"
},
{
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"text": "At this stage, uh, what, what we'd recommend is just what we say conservative management. So, um, I don't think you need anything like antibiotics. It's really just, um, making sure you're well hydrated, so drinking fluids.",
"speaker": "Doctor"
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"speaker": "Patient"
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"text": "Mm-hmm.",
"speaker": "Patient"
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{
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"text": "Um, there are things like Dioralyte you can get from the pharmacy, which uh it's um it helps helps replenish your minerals and vitamins.",
"speaker": "Doctor"
},
{
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"end": 392.76236,
"text": "Okay.",
"speaker": "Patient"
},
{
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"text": "Um, and if you are having vomiting diarrhea I would say recommend that in the first, you know, first couple of days.",
"speaker": "Doctor"
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{
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"end": 398.15448,
"text": "Yep.",
"speaker": "Patient"
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{
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"text": " If you are feeling feverish and weak, eh taking some paracetamol, uh, two tablets up to four times a day for the first few days can also help.",
"speaker": "Doctor"
},
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"text": "Yep.",
"speaker": "Patient"
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"text": "I will certainly advise you to take some time off work, actually I know you're quite keen to work but I would say the next two, two to three days as the infection clears from your system to take some time off and rest.",
"speaker": "Doctor"
},
{
"start": 409.50735,
"end": 410.50735,
"text": "Okay.",
"speaker": "Patient"
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"end": 414.58576,
"text": "Yeah.",
"speaker": "Patient"
},
{
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"end": 425.30126,
"text": "Um, I'll admit if your symptoms haven't got better, you know, in in three to four days, I'd like to come and see you again. ",
"speaker": "Doctor"
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{
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"end": 425.70334,
"text": "Okay, sure.",
"speaker": "Patient"
},
{
"start": 425.30126,
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"text": "Because if it is ongoing then we have to wonder whether something else caused your symptoms.",
"speaker": "Doctor"
},
{
"start": 429.19351,
"end": 430.19351,
"text": "Yep.",
"speaker": "Patient"
},
{
"start": 429.2709,
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"text": "Uh, and we may need to do further tests like um taking a sample of your stool so we can test that.",
"speaker": "Doctor"
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"text": "Um, etcetera etcetera.",
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"text": "Yep, sure, yep.",
"speaker": "Patient"
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"text": "How's that sound?",
"speaker": "Doctor"
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"text": "That sounds great, yeah. Yeah.",
"speaker": "Patient"
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"text": " Do you have any questions for me?",
"speaker": "Doctor"
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{
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"text": "Um, no, no further questions, no.",
"speaker": "Patient"
},
{
"start": 446.45245,
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"text": "Okay, and is uh is the treatment plan clear?",
"speaker": "Doctor"
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{
"start": 449.39454,
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"text": "Uh, yes, yeah, that's that's very clear. Thank you.",
"speaker": "Patient"
},
{
"start": 452.06427,
"end": 453.52581,
"text": "Great. Well, I wish you all the best.",
"speaker": "Doctor"
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{
"start": 453.46787,
"end": 456.17374,
"text": "Okay, thank you. Bye.",
"speaker": "Patient"
},
{
"start": 454.25656,
"end": 456.89117,
"text": " Thank you. Bye bye.",
"speaker": "Doctor"
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"doctor_utterances": "Hello? Hi. Um, should we start? Yeah, okay. Hello how um. Good morning sir, how can I help you this morning? Sorry to hear that. Um, and and when you say diarrhea, what'd you mean by diarrhea? Do you mean you're going to the toilet more often? Or are your stools more loose? Okay. And how many times a day are you going, let's say, in the last couple of days? Six, seven times a day. And you mention it's mainly watery. Have you noticed any other things, like blood in your stools? Okay. And you mentioned you've had some pain in your tummy as well. Whereabouts is the pain, exactly? One side. And what side is that? Left side. Okay, and can you describe the pain to me? Okay. And is the pain, is that, is it there all the time, or does it come and go? Come and go. Does the pain move anywhere else, for example towards your back? Okay, fine. And you mentioned you've been feeling quite weak and shaky as well. What do you mean by shaky? Do you mean you've been having, uh have you been feeling feverish, for example? You measure your temperature then? Okay. Okay. Any other symptoms like sweating, or um, night sweats? No? And, uh, any vomiting at all? You stopped vomiting, okay. And was your vomit, I know it's not a nice thing to talk about, but was it just normal food colour Yeah. And there was no blood in your vomit, is that right? No, okay. Um, and um, any any other symptoms at all? So you mentioned tummy pain, you mentioned diarrhea, you mentioned your vomiting, uh, anything else that comes to mind? Okay. Okay, so you're drinking fluids. Um, what kind of foods have you managed to eat, if anything? Okay. Fine. Um, and sir these started three days ago the symptoms. Are you aware of any triggers which may have caused the symptoms uh to kick on. So for example, think like takeaway foods or eating out or being around other people with similar symptoms. Okay. Do you remember where you ate? Okay. Anyone else unwell with similar symptoms? Okay, okay. Fine. Um, alright. And uh, in terms of your , your overall health, are you normally fit and well? Or, uh Okay. And, is your asthma well-controlled? Fine. And you don't have any other tummy problem, bowel problems I should be aware of? No, okay. Um, and apart from the inhalers, do you take any other medications? Okay, fine. And in terms of just your day to day life, you said it's been affecting your life, um, in what way has it been affecting your life? Okay. Yeah. And have you, are you currently working at the moment? Would, would work. Okay. Have you been going into work the last three days, or have you been at home? okay. That must be difficult for you then. fine. And you said, you mentioned you live with your wife and two children, is that right? Right, alright. Um, just a couple of other question we need to ask, sir. Um, do you smoke at all? And do you drink much in the way of alcohol? Okay. so um, er normally at this stage I like to um, examine you if that's okay, but um, um, but but having listened to your story, sir, I think uh, um, just to recap for the last three days you've been having loose stool, diarrhea, a bit of tummy pain uh mainly on the left-hand side, um and vomiting and fever and you're quite weak and lethargic um, you mentioned you had this Chinese takeaway as little as three days ago and I wondered whether that might be the cause of your problems. Um, it seems like you may have something, uh, called gastroenteritis, which essentially just a tummy bug or infection of your uh of your tummy. Uh, mainly caused by viruses but there can be a possibility of bacteria uh causing its symptoms. Um. At this stage, uh, what, what we'd recommend is just what we say conservative management. So, um, I don't think you need anything like antibiotics. It's really just, um, making sure you're well hydrated, so drinking fluids. Um, there are things like Dioralyte you can get from the pharmacy, which uh it's um it helps helps replenish your minerals and vitamins. Um, and if you are having vomiting diarrhea I would say recommend that in the first, you know, first couple of days. If you are feeling feverish and weak, eh taking some paracetamol, uh, two tablets up to four times a day for the first few days can also help. I will certainly advise you to take some time off work, actually I know you're quite keen to work but I would say the next two, two to three days as the infection clears from your system to take some time off and rest. Um, I'll admit if your symptoms haven't got better, you know, in in three to four days, I'd like to come and see you again. Because if it is ongoing then we have to wonder whether something else caused your symptoms. Uh, and we may need to do further tests like um taking a sample of your stool so we can test that. Um, etcetera etcetera. How's that sound? Do you have any questions for me? Okay, and is uh is the treatment plan clear? Great. Well, I wish you all the best. Thank you. Bye bye.",
"patient_utterances": "Hello, how are you? Oh hey, um, I've just had some diarrhea for the last three days, um, and it's been affecting me I need to stay close to the toilet. And, um, yeah, it's been affecting my day-to-day activities. Yeah, so it's like loose and watery stool, going to the toilet quite often, uh and like some pain in my, like, lower stomach? Um, probably like six or seven times a day? Yeah. No, no blood, yeah, just watery and loose stool. Yep. So in my lower abdomen, so, uh, like, um...yeah, just to one side. Uh, on the left side. Yeah, it feels, um, like a cramp, like a muscular cramp, and, um, yeah i feel a bit uh weak and shaky. Uh, it comes and goes. Uh...no, just maybe my stomach. Yeah. Um, yeah, it doesn't feel like -- yeah, it just makes me feel weak. I haven't had a fever, um, at the moment, but I did notice um a temperature when the symptoms started, so, um, yeah around about three or four days ago. Yeah, I uh I didn't mention my temperature, no, but I felt, um, just a bit hot. And, y'know. Uh, no. Yeah, so um, I vomited at the start of the symptoms but now um I've stopped vomiting. Yeah, yeah, just normal vomit, yeah. No no blood, no. Yeah. Yep. Um, I had a loss of appetite, um, so I haven't been eating as much, but I've been able to hold down fluids. Yep. Um, just soups, and, uh, yeah, light foods. Like smoothies and, yeah, liquid foods mainly. Yeah, so I had takeaway about four days ago, um, uh, but other than that I've, yeah, been, uh, eating normally. Nothing unusual here. Um, yeah, I ate at a Chinese restaurant with friends. Yeah. Um, so no one else in the family, so a wife and two kids and one, um, child was vomiting, but they haven't got diarrhea. There's no one with the same symptoms. Um, yeah, I mean, other than um athsma, um I use an inhaler, everything uh else is fine. Uh, yeah, that's fine. I just, yeah, use an inhaler, and uh that's under control. No. Uh, no, no other medications. Yeah. Uh, so, I need to stay close to the toilet 'cause I go quite frequently during the these past three days. Um, yeah, other than that, it's uh, yeah, the main concern. Uh, yes, yeah. I I work, er. Um, I'm an accountant. Uh, yeah, I've been going to work. Yeah. Yeah, it's been quite difficult. Yes, yeah. Uh, no, I don't smoke. Uh, no, I I don't drink alcohol, no. Yeah. Okay. Yeah. Yeah. Mm-hmm. Okay. Yep. Yep. Okay. Yeah. Okay, sure. Yep. Yep, sure, yep. That sounds great, yeah. Yeah. Um, no, no further questions, no. Uh, yes, yeah, that's that's very clear. Thank you. Okay, thank you. Bye.",
"num_turns": 105,
"reference_note": "{\"day\": 1, \"consultation\": 1, \"presenting_complaint\": \"I've been having really bad diarrhea for the last 3 days\", \"note\": \"3/7 hx of diarrhea, mainly watery. No blood in stool. Opening bowels x6/day. Associated LLQ pain - crampy, intermittent, nil radiation. Also vomiting - mainly bilous. No blood in vomit. Fever on first day, nil since. Has been feeling lethargic and weak since. \\n\\nTakeaway 4/7 ago - Chinese restaurant. Wife and children also unwell with vomiting, but no diarrhea. No other unwell contacts. \\n\\nPMH: Asthma\\nDH: Inhalers\\nSH: works as an accountant. Lives with wife and children. Affecting his ADLs as has to be near toilet often. \\nNil smoking/etOH hx\\n\\nImp: gastroenteritis \\n\\nPlan:\\nConservative management - rest, push fluids, paracetamol if feverish. Recommend OTC diarolyte. To review in 3-5d if symptoms not improving. To see earlier if feeling more unwell. \\n\", \"highlights\": [\"3/7 hx of diarrhea\", \"LLQ pain\", \"Fever\", \"gastroenteritis\", \"Conservative management\"]}",
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"dialogue": "[Doctor] Hello?\n[Patient] Hello. Can you hear me well?\n[Doctor] Uh uh yes. I think. It's a bit better. It's a bit, it's a bit, it's not very clear. But let's continue anyway.\n[Patient] OK.\n[Doctor] Uh, OK. Let's start again. So how can I help you sir?\n[Patient] Yes. So, it's been a few days now. I have like a sore, and a red skin. It's kind of, it's really itchy, and it's like super annoying. So I'd like to find something quick to solve it.\n[Doctor] OK.\n[Doctor] No, no problem. I'm happy to help. Um whereabouts in your skin is it affected?\n[Patient] Uh, mostly like my chest, my, my hands, my arms. Like, like really, it's it's super annoying. Like it's itching a lot, like all the time. And I can't even sleep at night. I really need something quickly to, to solve it. Because even at work I, I can, when I'm in a meeting and I have to, like uh think about my work, I can't focus, I can't actually focus on my work. It's really annoying because I can't actually think about, uh, what I have to say. I'm always like, uh, disturbed by this disease.\n[Doctor] Yeah.\n[Doctor] \n[Doctor] No no, OK. I'm certain this is obviously affecting you. And uh we'll try our very best to get get this sorted out for you. Um, have you had anything like this before in the past?\n[Patient] Um so yes. Uh earlier I was like prescribed for my eczema.\n[Doctor] OK.\n[Patient] And they gave me like some cream, and something to, uh when I like shower, when I was in the shower, had to put something. But um\n[Doctor] OK.\n[Doctor] Did it help?\n[Patient] Um I mean, at that time yes. That's, those symptoms, like these symptoms appear like, when the symptoms appeared again, I tried those and it didn't work. I've tried a few things. Like I bought a, a steroid cream at the pharmacy last night. But it apparently didn't help, because it's still itching a lot today. Uh, yeah.\n[Doctor] OK. OK. Do you remember the name of the cream you bought?\n[Patient] A steroid cream.\n[Doctor] OK, steroid, OK. um would you say these symptoms are very similar to your eczema symptoms, or different?\n[Patient] Um it's much more like itchy. And my eczema was more like only in the arm. But now it's also on the chest. And in the on the, on the hands as well.\n[Doctor] OK.\n[Patient] Like pretty, yeah when, like I like, for instance hiking, during the weekend. And\n[Doctor] \n[Patient] I am, I can't really do it anymore, because it's like very like I wanted to do that last weekend. And because super painful, and I I have to take like showers every day to be able to, cannot uh ease this itching part, which is very very annoying.\n[Doctor] Yes.\n[Doctor] No. Well OK. That's so you mentioned the itchiness. Um you also mentioned it's been quite sore.\n[Patient] Yeah.\n[Doctor] Um have you, have you noticed any uh bleeding or discharge from your skins?\n[Patient] . OK.\n[Patient] No. Um so my skin is a bit cracked in some parts, like kind of cracked, if you see what I mean. But uh, yeah.\n[Doctor] OK. You've not, haven't uh seen any other uh pus or blood, coming out of your skin.\n[Patient] No.\n[Doctor] No. And you mentioned it all started three days ago. Are you, four days ago. Are you aware of any triggers, or anything that you may have done, that may have caused your symptoms to start?\n[Patient] Four days ago.\n[Doctor] So for example, have you changed your uh shower gel, any clothing? Have you been around anyone else?\n[Patient] No I . It's actually like, it's really annoying, because I'm thinking about, maybe I should change something. Because I I haven't, and I don't understand I cannot, um afraid of asking people around me because it's cannot you know um, I don't feel really comfortable asking about these questions. It's kind of intimate that. So I your help now.\n[Doctor] Mm. Mm. No no, OK. That's OK. Um Fine, so just to resummarize. For the last four days, you've had very itchy skin, very sore skin all over your body, mainly your chest. And did you also mention your arms and legs as well?\n[Patient] Yeah.\n[Patient] Uh, no. Just the chest, hands and like, like inside the elbows. Yeah.\n[Doctor] \n[Doctor] OK. anything on your face at all?\n[Patient] Am I what?\n[Doctor] On your face?\n[Patient] On my face? No.\n[Doctor] No, OK. And apart from this, any other symptoms have you noticed? For example, have you noticed any temperature or fevers?\n[Patient] No. just very itchy. Nothing else.\n[Doctor] Itchy. OK. So your, your bowels are working OK? Your chest is OK? No cough, no breathing difficulties?\n[Patient] No.\n[Doctor] You're passing urine OK.\n[Patient] I I think so.\n[Doctor] OK, alright. Um It's always good to know. So, I mean, do you have any ideas as to what could be causing your symptoms?\n[Patient] Any what?\n[Doctor] Any ideas, as to what could be causing your symptoms?\n[Patient] Um so I had eczema before. So maybe it's disease, but it seems like more uh, like uh my eczema was only on the arms. So, I'm I'm not sure. I I really have no idea.\n[Doctor] OK. That's OK. So um, normally at this stage I like to examine you. Um To see the rash itself, to see exactly what type of rash it is. But from what you've told me, you mentioned it's, you've got some dry skin and some, uh cracked skin as well. Uh and has been very itchy. And so would your um\n[Patient] Yeah.\n[Doctor] Uh your your background of eczema. Um So Sorry to say, there's a couple of questions I wanted to ask you, which I completely forgot, my apologies. Um, apart from the eczema, do you have any other medical problems I should be aware of?\n[Patient] Uh, no. I just had asthma in the past. But not anymore.\n[Doctor] OK. Not anymore, OK. And do you take any regular medications at the moment?\n[Patient] Uh no.\n[Doctor] No, OK. Do you have any allergies to anything?\n[Patient] I like some , sorry? Yeah?\n[Doctor] sorry I said do you have any allergies to anything?\n[Doctor] Hello?\n[Patient] Hello? Yes.\n[Doctor] can you hear me? That's alright I think it . Uh do you have any allergies at all?\n[Patient] Ohh, allergies. Uh, no.\n[Doctor] No, OK. Um and tell me about your um uh your situation at home. Who do you live with?\n[Patient] Uh so, I live with a few flatmates. I'm a, so you know I'm thirty one. Uh I, yeah I'm I have a full time job. And so I'm living with a few people to save money.\n[Doctor] OK. And what do you do for work?\n[Patient] Uh I work uh at a pharmaceutical company. So it's been a, it's been a few years now. Uh it's uh, it's kind of interesting. We're working I'm a, like a kind of project manager. Uh I mean, do you want to, to know more about it?\n[Doctor] OK. Uh no no no that's , that's absolutely fine. Um just a couple of questions I want to ask you, which can sometimes affect your symptoms, is, do you smoke at all?\n[Patient] No.\n[Doctor] No. And do you drink much in the way of alcohol?\n[Patient] \n[Patient] Uh you know, once in a while I can, I like hanging out with people once in a while. So yeah I'd say a few, a few beers per week. Something like this. Nothing, nothing crazy. I used to drink a lot more when I was younger. But it's been, it's been a while. \n[Doctor] OK. OK. OK I've got to say, at this stage I've got to say this sound quality is not uh great. But I will continue because we've come this far. Um So um, based on everything you mentioned Sarah , I do wonder whether this is a flare-up of your eczema. Um\n[Patient] \n[Doctor] The reason being that you said it was quite itchy. Um it's mainly affecting your chest and your back. Um and uh, having looked at your skin, uh the the the rash does appear quite familiar. Um you mentioned using steroid creams, yesterday.\n[Patient] \n[Doctor] Um from the pharmacy. I wonder whether giving you a stronger prescription of a of a steroid may be beneficial. Uh, which I'm happy to prescribe to you today. As well as, I'm going to give you something, some emollients, which helps to moisturize the skin.\n[Patient] OK.\n[Patient] OK.\n[Doctor] Um which use in the bath and shower. And it's definitely worth um using that for the first seven to ten days.\n[Patient] OK.\n[Doctor] Uh before we make the decision on whether it's working or not.\n[Patient] OK.\n[Doctor] Um it's also worth um using antihistamines, which you can sometimes buy over counter. Things like Loratadine or Piriton, which can help the itchiness of your skin.\n[Patient] OK.\n[Doctor] And uh, um it's also worth keeping a diary of any triggers which are affecting your symptoms, anything you wear or anything you use, in terms of shower gels or soap. Because if that's causing your symptoms, then we need to have a discussion about an eczema CU.\n[Patient] OK. Yes, I have tried antihistamines, uh lately, but it didn't really help.\n[Doctor] Ohh, could you say that again, sorry?\n[Patient] I have tried uh antihistamines, but uh but it didn't really help.\n[Doctor] OK.\n[Doctor] OK. So it's something for you to think about. you can get different types of antihistamines. I can give you something a little bit stronger today as well. Um, something like Fexofenadine, which I can give to you today. It's definitely worth trying, and it's not going to do you any harm.\n[Patient] OK.\n[Doctor] Um but I think using the steroids and the emollients, um on a regular basis Uh over the next week to ten days, should hopefully control your symptoms. But do come back and see me next week, if things don't get better.\n[Patient] That sounds good.\n[Doctor] OK? Um do you have any questions for me?\n[Patient] Uh, no that's it. Thank you very much. Bye. Thank you as well. Bye.\n[Doctor] OK. Well I wish you all the best. Thank you. Have a good day.",
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"text": "So for example, have you changed your uh shower gel, any clothing? Have you been around anyone else?",
"speaker": "Doctor"
},
{
"start": 195.41753,
"end": 215.1749,
"text": "No I . It's actually like, it's really annoying, because I'm thinking about, maybe I should change something. Because I I haven't, and I don't understand I cannot, um afraid of asking people around me because it's cannot you know um, I don't feel really comfortable asking about these questions. It's kind of intimate that. So I your help now.",
"speaker": "Patient"
},
{
"start": 213.13955,
"end": 228.11174,
"text": "Mm. Mm. No no, OK. That's OK. Um Fine, so just to resummarize. For the last four days, you've had very itchy skin, very sore skin all over your body, mainly your chest. And did you also mention your arms and legs as well?",
"speaker": "Doctor"
},
{
"start": 225.91398,
"end": 226.61183,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 229.60027,
"end": 235.56612,
"text": "Uh, no. Just the chest, hands and like, like inside the elbows. Yeah.",
"speaker": "Patient"
},
{
"start": 231.57702,
"end": 232.18118,
"text": "",
"speaker": "Doctor"
},
{
"start": 234.49368,
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"text": "OK. anything on your face at all?",
"speaker": "Doctor"
},
{
"start": 238.05887,
"end": 238.97584,
"text": "Am I what?",
"speaker": "Patient"
},
{
"start": 238.7159,
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"text": "On your face?",
"speaker": "Doctor"
},
{
"start": 240.68663,
"end": 241.88494,
"text": "On my face? No.",
"speaker": "Patient"
},
{
"start": 241.6395,
"end": 247.377,
"text": "No, OK. And apart from this, any other symptoms have you noticed? For example, have you noticed any temperature or fevers?",
"speaker": "Doctor"
},
{
"start": 248.82474,
"end": 251.79794,
"text": "No. just very itchy. Nothing else.",
"speaker": "Patient"
},
{
"start": 250.41866,
"end": 259.05059,
"text": "Itchy. OK. So your, your bowels are working OK? Your chest is OK? No cough, no breathing difficulties?",
"speaker": "Doctor"
},
{
"start": 259.99695,
"end": 260.6405,
"text": "No.",
"speaker": "Patient"
},
{
"start": 261.14086,
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"text": "You're passing urine OK.",
"speaker": "Doctor"
},
{
"start": 264.40274,
"end": 265.57554,
"text": "I I think so.",
"speaker": "Patient"
},
{
"start": 265.5228,
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"text": "OK, alright. Um It's always good to know. So, I mean, do you have any ideas as to what could be causing your symptoms?",
"speaker": "Doctor"
},
{
"start": 275.18163,
"end": 276.02973,
"text": "Any what?",
"speaker": "Patient"
},
{
"start": 275.93251,
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"text": "Any ideas, as to what could be causing your symptoms?",
"speaker": "Doctor"
},
{
"start": 279.40653,
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"text": "Um so I had eczema before. So maybe it's disease, but it seems like more uh, like uh my eczema was only on the arms. So, I'm I'm not sure. I I really have no idea.",
"speaker": "Patient"
},
{
"start": 288.64776,
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"text": " OK. That's OK. So um, normally at this stage I like to examine you. Um To see the rash itself, to see exactly what type of rash it is. But from what you've told me, you mentioned it's, you've got some dry skin and some, uh cracked skin as well. Uh and has been very itchy. And so would your um",
"speaker": "Doctor"
},
{
"start": 304.70489,
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"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 308.9255,
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"text": "Uh your your background of eczema. Um So Sorry to say, there's a couple of questions I wanted to ask you, which I completely forgot, my apologies. Um, apart from the eczema, do you have any other medical problems I should be aware of?",
"speaker": "Doctor"
},
{
"start": 320.49329,
"end": 325.13095,
"text": "Uh, no. I just had asthma in the past. But not anymore.",
"speaker": "Patient"
},
{
"start": 324.1963,
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"text": "OK. Not anymore, OK. And do you take any regular medications at the moment?",
"speaker": "Doctor"
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{
"start": 329.50775,
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"text": "Uh no.",
"speaker": "Patient"
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{
"start": 331.03656,
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"text": "No, OK. Do you have any allergies to anything?",
"speaker": "Doctor"
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{
"start": 332.99283,
"end": 335.62366,
"text": "I like some , sorry? Yeah?",
"speaker": "Patient"
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{
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"text": " sorry I said do you have any allergies to anything?",
"speaker": "Doctor"
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{
"start": 345.7032,
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"text": " Hello?",
"speaker": "Doctor"
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{
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"text": "Hello? Yes.",
"speaker": "Patient"
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{
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"text": " can you hear me? That's alright I think it . Uh do you have any allergies at all?",
"speaker": "Doctor"
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"text": "Ohh, allergies. Uh, no.",
"speaker": "Patient"
},
{
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"text": "No, OK. Um and tell me about your um uh your situation at home. Who do you live with?",
"speaker": "Doctor"
},
{
"start": 362.91341,
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"text": "Uh so, I live with a few flatmates. I'm a, so you know I'm thirty one. Uh I, yeah I'm I have a full time job. And so I'm living with a few people to save money.",
"speaker": "Patient"
},
{
"start": 375.14065,
"end": 376.87676,
"text": "OK. And what do you do for work?",
"speaker": "Doctor"
},
{
"start": 377.65247,
"end": 392.76834,
"text": "Uh I work uh at a pharmaceutical company. So it's been a, it's been a few years now. Uh it's uh, it's kind of interesting. We're working I'm a, like a kind of project manager. Uh I mean, do you want to, to know more about it?",
"speaker": "Patient"
},
{
"start": 392.70311,
"end": 401.82115,
"text": "OK. Uh no no no that's , that's absolutely fine. Um just a couple of questions I want to ask you, which can sometimes affect your symptoms, is, do you smoke at all?",
"speaker": "Doctor"
},
{
"start": 402.88423,
"end": 403.59602,
"text": "No.",
"speaker": "Patient"
},
{
"start": 403.49476,
"end": 406.07114,
"text": "No. And do you drink much in the way of alcohol?",
"speaker": "Doctor"
},
{
"start": 404.84783,
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"text": "",
"speaker": "Patient"
},
{
"start": 407.07263,
"end": 420.26097,
"text": "Uh you know, once in a while I can, I like hanging out with people once in a while. So yeah I'd say a few, a few beers per week. Something like this. Nothing, nothing crazy. I used to drink a lot more when I was younger. But it's been, it's been a while. ",
"speaker": "Patient"
},
{
"start": 418.50167,
"end": 433.87255,
"text": "OK. OK. OK I've got to say, at this stage I've got to say this sound quality is not uh great. But I will continue because we've come this far. Um So um, based on everything you mentioned Sarah , I do wonder whether this is a flare-up of your eczema. Um",
"speaker": "Doctor"
},
{
"start": 427.5363,
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"text": "",
"speaker": "Patient"
},
{
"start": 433.87255,
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"text": "The reason being that you said it was quite itchy. Um it's mainly affecting your chest and your back. Um and uh, having looked at your skin, uh the the the rash does appear quite familiar. Um you mentioned using steroid creams, yesterday.",
"speaker": "Doctor"
},
{
"start": 441.50725,
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"text": "",
"speaker": "Patient"
},
{
"start": 451.09372,
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"text": "Um from the pharmacy. I wonder whether giving you a stronger prescription of a of a steroid may be beneficial. Uh, which I'm happy to prescribe to you today. As well as, I'm going to give you something, some emollients, which helps to moisturize the skin.",
"speaker": "Doctor"
},
{
"start": 459.08688,
"end": 459.94195,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 462.07238,
"end": 462.85499,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 465.96792,
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"text": "Um which use in the bath and shower. And it's definitely worth um using that for the first seven to ten days.",
"speaker": "Doctor"
},
{
"start": 466.20281,
"end": 467.20281,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 473.20635,
"end": 476.79576,
"text": "Uh before we make the decision on whether it's working or not.",
"speaker": "Doctor"
},
{
"start": 473.47814,
"end": 474.24626,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 476.79576,
"end": 489.38691,
"text": "Um it's also worth um using antihistamines, which you can sometimes buy over counter. Things like Loratadine or Piriton, which can help the itchiness of your skin.",
"speaker": "Doctor"
},
{
"start": 487.85489,
"end": 488.85489,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 489.38691,
"end": 503.79752,
"text": "And uh, um it's also worth keeping a diary of any triggers which are affecting your symptoms, anything you wear or anything you use, in terms of shower gels or soap. Because if that's causing your symptoms, then we need to have a discussion about an eczema CU.",
"speaker": "Doctor"
},
{
"start": 504.01423,
"end": 509.34754,
"text": "OK. Yes, I have tried antihistamines, uh lately, but it didn't really help.",
"speaker": "Patient"
},
{
"start": 510.41834,
"end": 512.04086,
"text": "Ohh, could you say that again, sorry?",
"speaker": "Doctor"
},
{
"start": 512.31855,
"end": 516.75331,
"text": "I have tried uh antihistamines, but uh but it didn't really help.",
"speaker": "Patient"
},
{
"start": 514.23954,
"end": 514.8753,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 516.66889,
"end": 529.61705,
"text": " OK. So it's something for you to think about. you can get different types of antihistamines. I can give you something a little bit stronger today as well. Um, something like Fexofenadine, which I can give to you today. It's definitely worth trying, and it's not going to do you any harm.",
"speaker": "Doctor"
},
{
"start": 523.76777,
"end": 524.36436,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 529.61705,
"end": 542.90184,
"text": "Um but I think using the steroids and the emollients, um on a regular basis Uh over the next week to ten days, should hopefully control your symptoms. But do come back and see me next week, if things don't get better.",
"speaker": "Doctor"
},
{
"start": 543.59377,
"end": 544.70971,
"text": "That sounds good.",
"speaker": "Patient"
},
{
"start": 544.70317,
"end": 547.25947,
"text": "OK? Um do you have any questions for me?",
"speaker": "Doctor"
},
{
"start": 547.84398,
"end": 555.81111,
"text": "Uh, no that's it. Thank you very much. Bye. Thank you as well. Bye.",
"speaker": "Patient"
},
{
"start": 549.5045,
"end": 553.76278,
"text": "OK. Well I wish you all the best. Thank you. Have a good day.",
"speaker": "Doctor"
}
],
"doctor_utterances": "Hello? Uh uh yes. I think. It's a bit better. It's a bit, it's a bit, it's not very clear. But let's continue anyway. Uh, OK. Let's start again. So how can I help you sir? OK. No, no problem. I'm happy to help. Um whereabouts in your skin is it affected? Yeah. No no, OK. I'm certain this is obviously affecting you. And uh we'll try our very best to get get this sorted out for you. Um, have you had anything like this before in the past? OK. OK. Did it help? OK. OK. Do you remember the name of the cream you bought? OK, steroid, OK. um would you say these symptoms are very similar to your eczema symptoms, or different? OK. Yes. No. Well OK. That's so you mentioned the itchiness. Um you also mentioned it's been quite sore. Um have you, have you noticed any uh bleeding or discharge from your skins? OK. You've not, haven't uh seen any other uh pus or blood, coming out of your skin. No. And you mentioned it all started three days ago. Are you, four days ago. Are you aware of any triggers, or anything that you may have done, that may have caused your symptoms to start? So for example, have you changed your uh shower gel, any clothing? Have you been around anyone else? Mm. Mm. No no, OK. That's OK. Um Fine, so just to resummarize. For the last four days, you've had very itchy skin, very sore skin all over your body, mainly your chest. And did you also mention your arms and legs as well? OK. anything on your face at all? On your face? No, OK. And apart from this, any other symptoms have you noticed? For example, have you noticed any temperature or fevers? Itchy. OK. So your, your bowels are working OK? Your chest is OK? No cough, no breathing difficulties? You're passing urine OK. OK, alright. Um It's always good to know. So, I mean, do you have any ideas as to what could be causing your symptoms? Any ideas, as to what could be causing your symptoms? OK. That's OK. So um, normally at this stage I like to examine you. Um To see the rash itself, to see exactly what type of rash it is. But from what you've told me, you mentioned it's, you've got some dry skin and some, uh cracked skin as well. Uh and has been very itchy. And so would your um Uh your your background of eczema. Um So Sorry to say, there's a couple of questions I wanted to ask you, which I completely forgot, my apologies. Um, apart from the eczema, do you have any other medical problems I should be aware of? OK. Not anymore, OK. And do you take any regular medications at the moment? No, OK. Do you have any allergies to anything? sorry I said do you have any allergies to anything? Hello? can you hear me? That's alright I think it . Uh do you have any allergies at all? No, OK. Um and tell me about your um uh your situation at home. Who do you live with? OK. And what do you do for work? OK. Uh no no no that's , that's absolutely fine. Um just a couple of questions I want to ask you, which can sometimes affect your symptoms, is, do you smoke at all? No. And do you drink much in the way of alcohol? OK. OK. OK I've got to say, at this stage I've got to say this sound quality is not uh great. But I will continue because we've come this far. Um So um, based on everything you mentioned Sarah , I do wonder whether this is a flare-up of your eczema. Um The reason being that you said it was quite itchy. Um it's mainly affecting your chest and your back. Um and uh, having looked at your skin, uh the the the rash does appear quite familiar. Um you mentioned using steroid creams, yesterday. Um from the pharmacy. I wonder whether giving you a stronger prescription of a of a steroid may be beneficial. Uh, which I'm happy to prescribe to you today. As well as, I'm going to give you something, some emollients, which helps to moisturize the skin. Um which use in the bath and shower. And it's definitely worth um using that for the first seven to ten days. Uh before we make the decision on whether it's working or not. Um it's also worth um using antihistamines, which you can sometimes buy over counter. Things like Loratadine or Piriton, which can help the itchiness of your skin. And uh, um it's also worth keeping a diary of any triggers which are affecting your symptoms, anything you wear or anything you use, in terms of shower gels or soap. Because if that's causing your symptoms, then we need to have a discussion about an eczema CU. Ohh, could you say that again, sorry? OK. OK. So it's something for you to think about. you can get different types of antihistamines. I can give you something a little bit stronger today as well. Um, something like Fexofenadine, which I can give to you today. It's definitely worth trying, and it's not going to do you any harm. Um but I think using the steroids and the emollients, um on a regular basis Uh over the next week to ten days, should hopefully control your symptoms. But do come back and see me next week, if things don't get better. OK? Um do you have any questions for me? OK. Well I wish you all the best. Thank you. Have a good day.",
"patient_utterances": "Hello. Can you hear me well? OK. Yes. So, it's been a few days now. I have like a sore, and a red skin. It's kind of, it's really itchy, and it's like super annoying. So I'd like to find something quick to solve it. Uh, mostly like my chest, my, my hands, my arms. Like, like really, it's it's super annoying. Like it's itching a lot, like all the time. And I can't even sleep at night. I really need something quickly to, to solve it. Because even at work I, I can, when I'm in a meeting and I have to, like uh think about my work, I can't focus, I can't actually focus on my work. It's really annoying because I can't actually think about, uh, what I have to say. I'm always like, uh, disturbed by this disease. Um so yes. Uh earlier I was like prescribed for my eczema. And they gave me like some cream, and something to, uh when I like shower, when I was in the shower, had to put something. But um Um I mean, at that time yes. That's, those symptoms, like these symptoms appear like, when the symptoms appeared again, I tried those and it didn't work. I've tried a few things. Like I bought a, a steroid cream at the pharmacy last night. But it apparently didn't help, because it's still itching a lot today. Uh, yeah. A steroid cream. Um it's much more like itchy. And my eczema was more like only in the arm. But now it's also on the chest. And in the on the, on the hands as well. Like pretty, yeah when, like I like, for instance hiking, during the weekend. And I am, I can't really do it anymore, because it's like very like I wanted to do that last weekend. And because super painful, and I I have to take like showers every day to be able to, cannot uh ease this itching part, which is very very annoying. Yeah. . OK. No. Um so my skin is a bit cracked in some parts, like kind of cracked, if you see what I mean. But uh, yeah. No. Four days ago. No I . It's actually like, it's really annoying, because I'm thinking about, maybe I should change something. Because I I haven't, and I don't understand I cannot, um afraid of asking people around me because it's cannot you know um, I don't feel really comfortable asking about these questions. It's kind of intimate that. So I your help now. Yeah. Uh, no. Just the chest, hands and like, like inside the elbows. Yeah. Am I what? On my face? No. No. just very itchy. Nothing else. No. I I think so. Any what? Um so I had eczema before. So maybe it's disease, but it seems like more uh, like uh my eczema was only on the arms. So, I'm I'm not sure. I I really have no idea. Yeah. Uh, no. I just had asthma in the past. But not anymore. Uh no. I like some , sorry? Yeah? Hello? Yes. Ohh, allergies. Uh, no. Uh so, I live with a few flatmates. I'm a, so you know I'm thirty one. Uh I, yeah I'm I have a full time job. And so I'm living with a few people to save money. Uh I work uh at a pharmaceutical company. So it's been a, it's been a few years now. Uh it's uh, it's kind of interesting. We're working I'm a, like a kind of project manager. Uh I mean, do you want to, to know more about it? No. Uh you know, once in a while I can, I like hanging out with people once in a while. So yeah I'd say a few, a few beers per week. Something like this. Nothing, nothing crazy. I used to drink a lot more when I was younger. But it's been, it's been a while. OK. OK. OK. OK. OK. OK. Yes, I have tried antihistamines, uh lately, but it didn't really help. I have tried uh antihistamines, but uh but it didn't really help. OK. That sounds good. Uh, no that's it. Thank you very much. Bye. Thank you as well. Bye.",
"num_turns": 103,
"reference_note": "{\"day\": 1, \"consultation\": 2, \"presenting_complaint\": \"I have sore, red skin\", \"note\": \"4/7 hx of dry itchy skin, mainly on chest and back. Skin is also sore and cracked. No bleeding or discharge. No spread elsewhere. Not aware of any triggers. Used steroid cream OTC last night with minimal effect. Pt has also tried antihistamines. \\nSystemically well otherwise - no fevers, no vomiting, no SOB/cough. No bowel sx. \\n\\nPMH: Eczema, Asthma \\nDHx: Nil regular\\nNKDA\\nSH: lives with flatmates, works as a pharmaceutical manager. Non-smoker, social EtOH. \\nICE: pt thinks might be related to eczema. No concerns\\n\\nImp: flare up of eczema\\n\\nPlan:\\n1.\\tSteroid cream - Betnovate BD\\n2.\\tEmollients - cetraben - use up to QDS\\n3.\\tTrial antihistamines\\n4.\\tKeep trigger diary \\n5.\\tReview in 10-14d if symptoms no better, or earlier if any concerns/worsening sx\\n\", \"highlights\": [\"4/7 hx of dry itchy skin\", \"Eczema\", \"Asthma\", \"Steroid cream\", \"Emmolients\"]}",
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"consultation_id": "day1_consultation03",
"dialogue": "[Doctor] Hello?\n[Patient] Hello.\n[Doctor] Hello there. It's uh Doctor here. How can I help you this afternoon?\n[Patient] Ohh, I just got a terrible headache since mid-day. Um on the left side. It's just making me feel so ill. I just feel like I need to vomit.\n[Doctor] I'm sorry to hear that. Um can you tell me a bit more about the headache?\n[Patient] Well you know, I noticed some zig-zag lines in my vision a few minutes before the headache started.\n[Doctor] \n[Doctor] Mm-hmm.\n[Patient] My vision blurred. Um, you know, it just I, yeah. Pain's just horrible. Just making me feel so unwell. Um\n[Doctor] Mm, OK. And \n[Patient] just want you to do something.\n[Doctor] Well, let's try our best. Let's try and get you, let's try and get you well, soon. Um you mentioned it's on your left hand side. Is that right? And it started at mid-day, a few hours ago.\n[Patient] Yeah.\n[Doctor] OK. Um did the pain come on quite suddenly? Or was it more of a gradual build up?\n[Patient] Don't know, really. It just happened.\n[Doctor] OK. And are you able to describe what kind of headache it was? For example, was it throbbing, or was it more of a sharp pain?\n[Patient] Yeah, I guess it's, yeah I guess it's throbbing, um on that left side.\n[Doctor] And is it moving anywhere else, at all?\n[Patient] No, but it's worse when I move.\n[Doctor] Uh OK. Is that when you move your neck?\n[Patient] Well, like if I lean forward, or like move my head or neck, yeah, headache gets worse.\n[Doctor] OK. Um\n[Patient] I'm just really worried. Like I've just been googling and like I've read, you know if your headache gets worse if you move, it could be a sign of brain cancer.\n[Doctor] OK. Is that all you're worried about?\n[Patient] cancer.\n[Doctor] Is that, is that all your main worries today?\n[Patient] Ohh yeah, yeah and I'd like, you know My, my friend's mum, she she recently died of a brain tumor. So, it's really concerning me actually.\n[Doctor] Oh dear, I'm sorry to hear that. I can, I can understand why it's affecting you. Um But why don't we, why don't we take a good history first, and let me examine you. And then we can have a little chat afterwards, and see what's going on here.\n[Patient] \n[Doctor] Um so you mentioned a few things. You mentioned a headache. You also mentioned some disease, like Lyme's, uh before the headaches came on. And your vision has been blurry as well. Is that right? Is that , is that on both eyes, or just in left, left eye?\n[Patient] Yeah.\n[Patient] Eh, feels like it some days.\n[Doctor] Both eyes, OK. Have you any difficulty with seeing bright lights, at all?\n[Patient] Yeah well I'm , wearing sunglasses right now. It's just, you know, the light's really hurting my eyes.\n[Doctor] Ohh, I see OK. Um and you mentioned that you felt quite nauseous. Have you vomited at all?\n[Patient] Yeah. I vomited twice.\n[Doctor] Twice, OK. Um earlier today, OK. Um, any temperatures or fevers?\n[Patient] Um, no I don't feel feverish.\n[Doctor] OK. Um, any other funny skin rashes that you may have noticed?\n[Patient] No, I haven't noticed anything like that.\n[Doctor] OK. Um fine. Um, and do you normally get headaches?\n[Patient] Um, I'm not really prone to them, no. No but I did, I did have a similar headache a few weeks ago.\n[Doctor] OK. And what happened then?\n[Patient] Just similar.\n[Doctor] How long did it last for?\n[Patient] Couple of days.\n[Doctor] Did you do anything that made it better?\n[Patient] Um yeah I had to take painkillers, and had to go go to bed and rest and\n[Doctor] Yeah.\n[Patient] couple days off work, and I work in the fashion industry. And you know, they're wondering what's going on, like I have to take sick days.\n[Doctor] \n[Doctor] Yeah. Yeah.\n[Patient] I need to get back to work today. But you know, what if it is a brain tumour? What's gonna happen with my future and my career?\n[Doctor] Yeah. Yeah. \n[Patient] You know, really about this. never had headaches like this before. Like why should I get them now?\n[Doctor] Yeah, sure. I mean I can see your concern obviously is a lot, there's a lot of worry there. Um but you know let let let, as I said let's take it step by step, um to see exactly what the cause of these headaches are first. Um, I'm just going to ask you some, um very uh yes no questions if that's OK, ma'am. Um Um have you noticed any problems with your speech at all, any difficulties with your words?\n[Patient] No.\n[Doctor] Any problems with your arms and legs? For example numbness or weakness?\n[Patient] No.\n[Doctor] Any difficulty with balance, your balance or coordination?\n[Patient] No.\n[Doctor] OK. And have you had any injuries to your head? Have you had a fall recently, or been knocked on the head?\n[Patient] No.\n[Doctor] OK, alright. Um and and you're feeling otherwise OK. So, for example your um Uh your your breathing's OK? You're not feeling breathless, or\n[Doctor] No, OK. Um do you have any other medical history I should be aware of?\n[Patient] No, nothing.\n[Doctor] No. So for example, have you had, has anyone told you you've had migraines in the past?\n[Patient] No.\n[Doctor] No, OK. Do you \n[Patient] No. My mum, my mum has, has migraines. But I've, I've not been diagnosed.\n[Doctor] OK. Right, my next question was that of family history. Is there anything in the family? So apart from migraines, is there anything else? Is there anything related to brain, for example?\n[Patient] as well.\n[Doctor] What was that, sorry?\n[Patient] My mom has an underactive thyroid as well.\n[Doctor] thyroid as well. OK. Um OK any other problems with for example, the brain, or? Um you mentioned brain cancer. Any other family history of ?\n[Patient] \n[Patient] No.\n[Doctor] No, OK. Um in terms of medications, do you take anything on a regular basis?\n[Patient] Um I take the pill, Microgynon.\n[Doctor] OK. And how long have you been on that for?\n[Patient] three months.\n[Doctor] Three months, OK. And is that mainly for contraception, or is that for something else?\n[Patient] it's for contraception.\n[Doctor] OK, alright. That's something you meant to have a little discussion about today as well. Um Uh well my next question was about um your social, your situation at home. You mentioned you work in the fashion industry. And your work, is your job quite stressful at the moment?\n[Patient] Yeah it's really stressful, actually.\n[Doctor] Have you been\n[Patient] having problems at like work, you know managers like putting a lot of pressure on me to deliver and, uh yeah it's not a good time.\n[Doctor] . Is it getting you down?\n[Patient] I don't feel down, just a little bit stressed.\n[Doctor] OK, alright. And what kind of things do you do to alleviate your stress, normally?\n[Patient] Nothing really.\n[Doctor] OK. Do you do much in the way of exercise?\n[Patient] No.\n[Doctor] No, OK. Um who's at home with you?\n[Patient] Um, I live on my own.\n[Doctor] OK. Um are you coping OK at the moment?\n[Patient] Fine.\n[Doctor] Yeah? OK. Um do you smoke at all? and do you drink much in the way of alcohol?\n[Patient] No.\n[Patient] No.\n[Doctor] OK, alright. Um, so normally at this I'd like to kind of proceed to examination. Um That's um based on your story, um I wonder whether you may, uh may have a migraine, uh migraine type headache. Uh it sounds Um, very classical of that, of that nature, the the the headache on one side, throbbing nature, the nausea, vomiting, um sensitivity to bright lights. Uh, I'm reassured that you don't have anything more serious, such as meningitis, or indeed Brain cancer, I know that was a big worry of yours initially. Um\n[Patient] thank you, uh thanks so much. I was so worried that I had cancer. And, ohh now you say migraine. Yeah I guess my mum has similar symptoms to me and yeah, it does make sense.\n[Doctor] yeah. Yeah. Well, I hope that puts your, you know, mind at ease. Um, certainly this is the second migraine you've had in the space of a month. Um, So I think, moving forwards, there's a couple of options. I think keeping a headache diary would be quite important, uh to see exactly what's triggering these headaches. And in terms of trying to treat your headaches today, some strong painkillers would be advisable. So, think about Paracetamol, or even Co-codamol. Um, and some anti-inflammatories, such as Ibuprofen and Naproxen. How's that sound to you?\n[Patient] K that sounds good.\n[Doctor] Um and uh, you know if your headaches were to become more persistent, then we could maybe think about giving you some medications that will stop your headaches from happening in the first place, something prophylactic medicines. then we could have a discussion next time I see you next week, perhaps.\n[Patient] OK.\n[Patient] OK.\n[Doctor] OK. Um, now a couple of things I want you to think about is, you know if your symptoms aren't getting better next two three days, or indeed they're getting worse. I'd like you to come back and see me, um straight away if possible. So if your headache's getting worse, not responding to medications Or your um neck pain is getting worse, or you develop any weakness in your arms and legs, or your vision, then I want you to come back and see me straight away. OK?\n[Patient] OK.\n[Doctor] Does that sound all OK?\n[Patient] Doctor, that's great.\n[Doctor] Great. Any questions for me?\n[Patient] No. Thank you.\n[Doctor] OK. Have a good day!\n[Patient] K thanks. Bye!\n[Doctor] Right.",
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"speaker": "Patient"
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"speaker": "Patient"
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"text": "No, OK. Um do you have any other medical history I should be aware of?",
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"text": "No. So for example, have you had, has anyone told you you've had migraines in the past?",
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"text": "No. My mum, my mum has, has migraines. But I've, I've not been diagnosed.",
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"text": "OK. Right, my next question was that of family history. Is there anything in the family? So apart from migraines, is there anything else? Is there anything related to brain, for example?",
"speaker": "Doctor"
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"text": " as well.",
"speaker": "Patient"
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"text": "What was that, sorry?",
"speaker": "Doctor"
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"text": "My mom has an underactive thyroid as well.",
"speaker": "Patient"
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"start": 312.24688,
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"text": " thyroid as well. OK. Um OK any other problems with for example, the brain, or? Um you mentioned brain cancer. Any other family history of ?",
"speaker": "Doctor"
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"speaker": "Patient"
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"speaker": "Patient"
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"text": "No, OK. Um in terms of medications, do you take anything on a regular basis?",
"speaker": "Doctor"
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"text": "Um I take the pill, Microgynon.",
"speaker": "Patient"
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"text": "OK. And how long have you been on that for?",
"speaker": "Doctor"
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"start": 334.72976,
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"text": " three months.",
"speaker": "Patient"
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"text": "Three months, OK. And is that mainly for contraception, or is that for something else?",
"speaker": "Doctor"
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"text": " it's for contraception.",
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"text": "OK, alright. That's something you meant to have a little discussion about today as well. Um Uh well my next question was about um your social, your situation at home. You mentioned you work in the fashion industry. And your work, is your job quite stressful at the moment?",
"speaker": "Doctor"
},
{
"start": 358.77445,
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"text": "Yeah it's really stressful, actually.",
"speaker": "Patient"
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"text": "Have you been",
"speaker": "Doctor"
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"start": 361.59191,
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"text": " having problems at like work, you know managers like putting a lot of pressure on me to deliver and, uh yeah it's not a good time.",
"speaker": "Patient"
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"text": ". Is it getting you down?",
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"speaker": "Patient"
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"text": "OK, alright. And what kind of things do you do to alleviate your stress, normally?",
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"text": "Nothing really.",
"speaker": "Patient"
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"speaker": "Doctor"
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"text": "No.",
"speaker": "Patient"
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"text": "No, OK. Um who's at home with you?",
"speaker": "Doctor"
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"text": "Um, I live on my own.",
"speaker": "Patient"
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"start": 391.85851,
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"text": "OK. Um are you coping OK at the moment?",
"speaker": "Doctor"
},
{
"start": 396.47849,
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"text": "Fine.",
"speaker": "Patient"
},
{
"start": 396.90904,
"end": 403.49616,
"text": "Yeah? OK. Um do you smoke at all? and do you drink much in the way of alcohol?",
"speaker": "Doctor"
},
{
"start": 400.57923,
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"text": "No.",
"speaker": "Patient"
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"start": 403.77359,
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"text": "No.",
"speaker": "Patient"
},
{
"start": 404.39423,
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"text": "OK, alright. Um, so normally at this I'd like to kind of proceed to examination. Um That's um based on your story, um I wonder whether you may, uh may have a migraine, uh migraine type headache. Uh it sounds Um, very classical of that, of that nature, the the the headache on one side, throbbing nature, the nausea, vomiting, um sensitivity to bright lights. Uh, I'm reassured that you don't have anything more serious, such as meningitis, or indeed Brain cancer, I know that was a big worry of yours initially. Um",
"speaker": "Doctor"
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"text": " thank you, uh thanks so much. I was so worried that I had cancer. And, ohh now you say migraine. Yeah I guess my mum has similar symptoms to me and yeah, it does make sense.",
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"text": " yeah. Yeah. Well, I hope that puts your, you know, mind at ease. Um, certainly this is the second migraine you've had in the space of a month. Um, So I think, moving forwards, there's a couple of options. I think keeping a headache diary would be quite important, uh to see exactly what's triggering these headaches. And in terms of trying to treat your headaches today, some strong painkillers would be advisable. So, think about Paracetamol, or even Co-codamol. Um, and some anti-inflammatories, such as Ibuprofen and Naproxen. How's that sound to you?",
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"text": "K that sounds good.",
"speaker": "Patient"
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"text": "Um and uh, you know if your headaches were to become more persistent, then we could maybe think about giving you some medications that will stop your headaches from happening in the first place, something prophylactic medicines. then we could have a discussion next time I see you next week, perhaps.",
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"text": "OK.",
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"text": "OK.",
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"text": "OK. Um, now a couple of things I want you to think about is, you know if your symptoms aren't getting better next two three days, or indeed they're getting worse. I'd like you to come back and see me, um straight away if possible. So if your headache's getting worse, not responding to medications Or your um neck pain is getting worse, or you develop any weakness in your arms and legs, or your vision, then I want you to come back and see me straight away. OK?",
"speaker": "Doctor"
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"text": "OK.",
"speaker": "Patient"
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"text": "Does that sound all OK?",
"speaker": "Doctor"
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"text": "Doctor, that's great.",
"speaker": "Patient"
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"text": "Great. Any questions for me?",
"speaker": "Doctor"
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"text": "No. Thank you.",
"speaker": "Patient"
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"text": "OK. Have a good day!",
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"text": "K thanks. Bye!",
"speaker": "Patient"
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"doctor_utterances": "Hello? Hello there. It's uh Doctor here. How can I help you this afternoon? I'm sorry to hear that. Um can you tell me a bit more about the headache? Mm-hmm. Mm, OK. And Well, let's try our best. Let's try and get you, let's try and get you well, soon. Um you mentioned it's on your left hand side. Is that right? And it started at mid-day, a few hours ago. OK. Um did the pain come on quite suddenly? Or was it more of a gradual build up? OK. And are you able to describe what kind of headache it was? For example, was it throbbing, or was it more of a sharp pain? And is it moving anywhere else, at all? Uh OK. Is that when you move your neck? OK. Um OK. Is that all you're worried about? Is that, is that all your main worries today? Oh dear, I'm sorry to hear that. I can, I can understand why it's affecting you. Um But why don't we, why don't we take a good history first, and let me examine you. And then we can have a little chat afterwards, and see what's going on here. Um so you mentioned a few things. You mentioned a headache. You also mentioned some disease, like Lyme's, uh before the headaches came on. And your vision has been blurry as well. Is that right? Is that , is that on both eyes, or just in left, left eye? Both eyes, OK. Have you any difficulty with seeing bright lights, at all? Ohh, I see OK. Um and you mentioned that you felt quite nauseous. Have you vomited at all? Twice, OK. Um earlier today, OK. Um, any temperatures or fevers? OK. Um, any other funny skin rashes that you may have noticed? OK. Um fine. Um, and do you normally get headaches? OK. And what happened then? How long did it last for? Did you do anything that made it better? Yeah. Yeah. Yeah. Yeah. Yeah. Yeah, sure. I mean I can see your concern obviously is a lot, there's a lot of worry there. Um but you know let let let, as I said let's take it step by step, um to see exactly what the cause of these headaches are first. Um, I'm just going to ask you some, um very uh yes no questions if that's OK, ma'am. Um Um have you noticed any problems with your speech at all, any difficulties with your words? Any problems with your arms and legs? For example numbness or weakness? Any difficulty with balance, your balance or coordination? OK. And have you had any injuries to your head? Have you had a fall recently, or been knocked on the head? OK, alright. Um and and you're feeling otherwise OK. So, for example your um Uh your your breathing's OK? You're not feeling breathless, or No, OK. Um do you have any other medical history I should be aware of? No. So for example, have you had, has anyone told you you've had migraines in the past? No, OK. Do you OK. Right, my next question was that of family history. Is there anything in the family? So apart from migraines, is there anything else? Is there anything related to brain, for example? What was that, sorry? thyroid as well. OK. Um OK any other problems with for example, the brain, or? Um you mentioned brain cancer. Any other family history of ? No, OK. Um in terms of medications, do you take anything on a regular basis? OK. And how long have you been on that for? Three months, OK. And is that mainly for contraception, or is that for something else? OK, alright. That's something you meant to have a little discussion about today as well. Um Uh well my next question was about um your social, your situation at home. You mentioned you work in the fashion industry. And your work, is your job quite stressful at the moment? Have you been . Is it getting you down? OK, alright. And what kind of things do you do to alleviate your stress, normally? OK. Do you do much in the way of exercise? No, OK. Um who's at home with you? OK. Um are you coping OK at the moment? Yeah? OK. Um do you smoke at all? and do you drink much in the way of alcohol? OK, alright. Um, so normally at this I'd like to kind of proceed to examination. Um That's um based on your story, um I wonder whether you may, uh may have a migraine, uh migraine type headache. Uh it sounds Um, very classical of that, of that nature, the the the headache on one side, throbbing nature, the nausea, vomiting, um sensitivity to bright lights. Uh, I'm reassured that you don't have anything more serious, such as meningitis, or indeed Brain cancer, I know that was a big worry of yours initially. Um yeah. Yeah. Well, I hope that puts your, you know, mind at ease. Um, certainly this is the second migraine you've had in the space of a month. Um, So I think, moving forwards, there's a couple of options. I think keeping a headache diary would be quite important, uh to see exactly what's triggering these headaches. And in terms of trying to treat your headaches today, some strong painkillers would be advisable. So, think about Paracetamol, or even Co-codamol. Um, and some anti-inflammatories, such as Ibuprofen and Naproxen. How's that sound to you? Um and uh, you know if your headaches were to become more persistent, then we could maybe think about giving you some medications that will stop your headaches from happening in the first place, something prophylactic medicines. then we could have a discussion next time I see you next week, perhaps. OK. Um, now a couple of things I want you to think about is, you know if your symptoms aren't getting better next two three days, or indeed they're getting worse. I'd like you to come back and see me, um straight away if possible. So if your headache's getting worse, not responding to medications Or your um neck pain is getting worse, or you develop any weakness in your arms and legs, or your vision, then I want you to come back and see me straight away. OK? Does that sound all OK? Great. Any questions for me? OK. Have a good day! Right.",
"patient_utterances": "Hello. Ohh, I just got a terrible headache since mid-day. Um on the left side. It's just making me feel so ill. I just feel like I need to vomit. Well you know, I noticed some zig-zag lines in my vision a few minutes before the headache started. My vision blurred. Um, you know, it just I, yeah. Pain's just horrible. Just making me feel so unwell. Um just want you to do something. Yeah. Don't know, really. It just happened. Yeah, I guess it's, yeah I guess it's throbbing, um on that left side. No, but it's worse when I move. Well, like if I lean forward, or like move my head or neck, yeah, headache gets worse. I'm just really worried. Like I've just been googling and like I've read, you know if your headache gets worse if you move, it could be a sign of brain cancer. cancer. Ohh yeah, yeah and I'd like, you know My, my friend's mum, she she recently died of a brain tumor. So, it's really concerning me actually. Yeah. Eh, feels like it some days. Yeah well I'm , wearing sunglasses right now. It's just, you know, the light's really hurting my eyes. Yeah. I vomited twice. Um, no I don't feel feverish. No, I haven't noticed anything like that. Um, I'm not really prone to them, no. No but I did, I did have a similar headache a few weeks ago. Just similar. Couple of days. Um yeah I had to take painkillers, and had to go go to bed and rest and couple days off work, and I work in the fashion industry. And you know, they're wondering what's going on, like I have to take sick days. I need to get back to work today. But you know, what if it is a brain tumour? What's gonna happen with my future and my career? You know, really about this. never had headaches like this before. Like why should I get them now? No. No. No. No. No, nothing. No. No. My mum, my mum has, has migraines. But I've, I've not been diagnosed. as well. My mom has an underactive thyroid as well. No. Um I take the pill, Microgynon. three months. it's for contraception. Yeah it's really stressful, actually. having problems at like work, you know managers like putting a lot of pressure on me to deliver and, uh yeah it's not a good time. I don't feel down, just a little bit stressed. Nothing really. No. Um, I live on my own. Fine. No. No. thank you, uh thanks so much. I was so worried that I had cancer. And, ohh now you say migraine. Yeah I guess my mum has similar symptoms to me and yeah, it does make sense. K that sounds good. OK. OK. OK. Doctor, that's great. No. Thank you. K thanks. Bye!",
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"reference_note": "{\"day\": 1, \"consultation\": 3, \"presenting_complaint\": \"I have terrible headache\", \"note\": \"Headache on left side. Started few hours ago, gradual onset. Throbbing in nature. Nil radiating. \\nHad visual aura before onset of headaches - zigzag lines in field of vision. Also associated photophobia and blurred vision. Feels nauseous and has vomited twice today. Also reports some neck pain. Nil neck stiffness. \\nNo speech disturbances\\nNo limb weakness or numbness\\nNo coordination/balance issues\\nNo recent head injury \\nNo fever\\nNo rashes \\n\\nSimilar episode 2/52 ago - resolved with analgesia. Pt worried about brain Ca. \\n\\nPMH: nil\\nDH: microgynon \\nNKDA\\nFH: mother - migraine \\nSH: lives alone, works in fashion industry. Feeling stressed ++. Nil mood sx. Nil smoking/etOH hx\\n\\nImp: migraine\\n\\nPlan:\\n1.\\tChange COCP to POP\\n2.\\tKeep headache diary \\n3.\\tRegular paracetamol/NSAIDs\\n4.\\tReview in 1w to discuss prophylactic Rx, or earlier if worsening sx (headaches, vomiting, vision sx) or any concerns\\n\", \"highlights\": [\"Headache\", \"Throbbing\", \"visual aura\", \"photophobia\", \"microgynon\", \"migraine\"]}",
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"dialogue": "[Doctor] Alex. Ohh. Hello? Hi, can you hear me?\n[Patient] \n[Patient] Yeah.\n[Doctor] OK great. Um how can I help you this morning, sir?\n[Patient] Alright, so I've been feeling, I've been feeling kind of uh under the weather for the past four days.\n[Doctor] \n[Patient] Um it started with the um, uh sore throat and runny nose, and It's sort of, um, it's sort of going into a cough now. Um, the sort throat is kind of going away, but, um, I'm starting to cough.\n[Doctor] Mm-hmm. OK.\n[Patient] And uh kind of uh bad and tired.\n[Doctor] Sorry to hear that .\n[Doctor] Mm. OK. I'm sorry to hear that. Seems like there's a lot going on there. Um so let's start with your, your sore throat first. Um tell me a bit more about that, if you can.\n[Patient] Um ,so I, I , you know I think I, it all started with, uh, this colleague of mine, she just kept sneezing next to me, all the time. I think her kids are catching something from the uh from their kindergarten or something. And uh, you know the it it started as normal sore throat, and uh was quite painful for a couple days, but then it was past.\n[Doctor] OK.\n[Doctor] OK. OK. And did you have any uh difficulty or pain on swallowing?\n[Patient] Um yeah. Yeah it was uh, it was quite painful to swallow, for one or two days.\n[Doctor] OK. You , did you manage to have a look at the back of your throat in the mirror?\n[Patient] Um no, not really.\n[Doctor] No. OK you didn't, you didn't notice any abnormal white spots, redness at the back of your throat?\n[Patient] Um No. Um I I didn't think about uh .\n[Doctor] \n[Doctor] that's OK. That's OK. And you mentioned a runny nose. Um again what kind of discharge is coming out? Is it clear, or is it a bit more coloured?\n[Patient] Yeah yeah, it's uh it's clearing up . Sort of um, sort of getting my nose stuffed all the time. It's very had to, uh to get it free.\n[Doctor] OK. You feel quite congested, do you?\n[Patient] Yeah, quite congested.\n[Doctor] OK, fine. Um you also mentioned a cough as well. Can you tell me a bit more about that?\n[Patient] Um yeah that started recently, like just uh um maybe yesterday. And um it's uh, it's dry for now, it's it's not very painful but it's sort of there, all the time.\n[Doctor] OK.\n[Doctor] OK. And is it worse any particular time of the day?\n[Patient] Sorry?\n[Doctor] Is it, is it worse any particular time of the day? For example in the evenings, night time, mornings?\n[Patient] Um\n[Doctor] throughout the day.\n[Patient] No it's it's um, it's sort of, it's sort of constant. Um I forgot to mention, that um I'm also having uh night sweats.\n[Doctor] OK.\n[Doctor] Night first, OK.\n[Patient] That's, that's very odd actually. makes me a bit tired, um makes my uneasy.\n[Doctor] Mm. \n[Doctor] I can imagine, yes. Uh and this has again, been going on for last uh three four days, has it?\n[Patient] Yeah, yes.\n[Doctor] OK. Um right, OK. Have you noticed any fevers or temperatures at all?\n[Patient] Um I I had some some fever in the beginning, but it's now sort of uh going down. I I've been taking some Paracetamol and Ibuprofen for that, and uh they, they help.\n[Doctor] OK.\n[Doctor] That's very sensible. Um very good. Um in terms of your chest otherwise, have you any difficulty breathing, or any pain in your chest?\n[Patient] Um so no pain in chest, but uh I noticed that I um um so I feel a bit winded on exertion. So if I I I haven't been going, going to the gym thus uh, because of that.\n[Doctor] When you say winded, do you feel, uh do you feel more short of breath would you say, on exertion? Is that when you, OK. Um and and that's mainly on exercise. But when you're resting, there's no problem.\n[Patient] yeah. \n[Patient] Yeah, yeah. When when when I'm resting it's OK. So I've been actually going to work, um sort of managing.\n[Doctor] OK. OK, fine. Just a couple other questions , if you don't mind. Any pain in, in your ears at all?\n[Patient] Um no.\n[Doctor] No, you don't feel blocked, or any discharge coming out of your ears?\n[Patient] \n[Patient] No, I don't think so.\n[Doctor] OK, fine. Um what I'm gonna do, I'm just gonna run through a few uh yes no questions, if you if you don't mind, just a review of your systems. Any, any headaches at all?\n[Patient] Um, yeah, yeah. That that's still, that's still there.\n[Doctor] Whereabouts are the head, headaches?\n[Patient] Um it's sort of general. Uh and uh they're not, they're not always there, but you know every now and then they will come and go.\n[Doctor] OK. And with those headaches have you had any problems with your, with your eyesight, your vision?\n[Patient] Um no.\n[Doctor] Uh any difficulty with seeing bright lights?\n[Patient] No, I don't think so.\n[Doctor] No, OK. Um and just moving down now, in terms of any, any feeling nausea or any vomiting?\n[Patient] No, none of that.\n[Doctor] OK. Tell me about your bowels. Are your bowels working OK?\n[Patient] Uh yeah, yeah. Think so.\n[Doctor] You're passing urine OK?\n[Patient] Yeah, yeah.\n[Doctor] How's your appetite, sir?\n[Patient] Yeah I've been, I've been drinking a lot more than the usual. But uh so other than that, so \n[Doctor] OK. Um and you're eating and drinking, uh you're eating OK otherwise.\n[Patient] Um maybe a bit less than uh than what I, I would usually have.\n[Doctor] OK. Um have you noticed any, any funny rashes at all, on your skin?\n[Patient] Um no, no.\n[Doctor] No. And any general muscle pain or aches, joint pain, ?\n[Patient] Yeah, yeah. Yeah that's, that sort of started in the past couple days.\n[Doctor] Yeah, OK. Alright um and uh just having a look at the rest of your history, are you otherwise fit and well? Or do you have any other medical problems I should be aware of?\n[Patient] Um, so otherwise that, uh, I'm I'm fine. There's um, there isn't anything that I'm taking or, I'm being treated for.\n[Doctor] OK. Um\n[Patient] Um\n[Doctor] So you are otherwise fit and well. Uh any, any allergies at all to any medications, I should be aware of?\n[Patient] Um, no \n[Doctor] No, OK. Um Any family history at all? So anything relevant in the family that I should be aware of? Anything like diabetes, high blood pressure?\n[Patient] Um, yeah my grandma has diabetes. Um, and, my grandma.\n[Doctor] \n[Doctor] Your brother?\n[Doctor] you say grandma, sorry my apologies. Grandma, OK. Uh do you know what type of diabetes it is? Is it type one, type two?\n[Patient] \n[Patient] I think , I think it's type two.\n[Doctor] OK. Um anything else which you think is significant?\n[Patient] Yeah, I, I think um, one of my uh, great grandads had an eczema.\n[Doctor] Excellent, OK. OK. Um just moving on to what we social history, just to get to know you a bit more as a person. Tell me, who do you live with at home?\n[Patient] Ohh um, I live alone.\n[Doctor] OK. And you said you're working at the moment?\n[Patient] Yeah, yeah.\n[Doctor] What do you do for work?\n[Patient] I'm an, I'm an accountant.\n[Doctor] OK, and how's your work going at the moment? Uh over the last, has it, has it been affecting your work?\n[Patient] Um, a little bit. I've been a bit slower. And you know, it's uh, it's, it's a bit of a stressful period just around the um, end of the year. Right.\n[Doctor] Mm, OK. Is that stress, is that affecting your um, your mood at all any, in any way?\n[Patient] Um, no I think I think it's, it's the, you know it's the good kind of stress. It's um, it's good work.\n[Doctor] OK. Well if there's anything you want to talk to me about, you can always come see me about your mood, um stress, anxiety. happy to help.\n[Patient] I don't know. I, I like my job. It's just you know, it's a bit more work than usual.\n[Doctor] OK. OK. And just very briefly, just in terms of smoking uh, do you smoke at all?\n[Patient] Um, yeah occasionally, you know, cigars and things on company parties.\n[Doctor] OK so not, not regular. Um and what about alcohol?\n[Patient] No.\n[Patient] Um, occasionally yeah I would have some. I'm, I'm not a very big drinker.\n[Doctor] socially with work.\n[Patient] Yeah.\n[Doctor] Um OK. Um so um just having listened to your story, um uh really just to summarize you know since the last four days you've been feeling generally quite unwell, sore throat, runny nose, bit of a dry cough, bit of muscle pain, weakness. Um had initial fever, but now settled. Um I don't think there's a lot to worry about. I think you probably have, you know a bit of a viral, what we say viral illness, maybe a viral upper respiratory tract infection, or maybe early signs of a flu. Um these normally last about seven to days and just gets better really, um over time. But things you can do to really help yourself, um is get plenty of rest. I'd probably advise you taking a day or two off work if you can. Um Making yourself, pushing fluids and make yourself well-hydrated. Continue with the regular Paracetamol, Ibuprofen. Um and and you should see how things go, really. Um if next week you're still not better, I'd like you to come back and see me. Um is that clear? Does that, does that make, does that make \n[Patient] Yeah, yeah, that's that's , it makes sense. Uh, I think I'll take a couple days off, and see how it goes.\n[Doctor] Yeah, yeah. and things to look out for if you're really not getting better, if you if you have a high fever, or your breathing is becoming a bit more labored, or chest pain, I'd like you to come back and see me much sooner, give me a call. Um and we can help you out. OK?\n[Patient] Yeah.\n[Patient] Yeah, yeah I understand. Uh, I'll uh, I'll take care.\n[Doctor] Great. Have a great day. Good luck with your work. Thank you. Bye bye. Bye bye.\n[Patient] Thank you. Thank you. You too. Bye bye.",
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"text": "Um yeah that started recently, like just uh um maybe yesterday. And um it's uh, it's dry for now, it's it's not very painful but it's sort of there, all the time.",
"speaker": "Patient"
},
{
"start": 147.18022,
"end": 147.9321,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 150.8945,
"end": 153.58623,
"text": "OK. And is it worse any particular time of the day?",
"speaker": "Doctor"
},
{
"start": 154.41782,
"end": 155.15883,
"text": "Sorry?",
"speaker": "Patient"
},
{
"start": 155.08998,
"end": 160.48095,
"text": "Is it, is it worse any particular time of the day? For example in the evenings, night time, mornings?",
"speaker": "Doctor"
},
{
"start": 160.93354,
"end": 161.6769,
"text": "Um",
"speaker": "Patient"
},
{
"start": 161.86441,
"end": 163.27794,
"text": " throughout the day.",
"speaker": "Doctor"
},
{
"start": 164.88548,
"end": 175.84236,
"text": "No it's it's um, it's sort of, it's sort of constant. Um I forgot to mention, that um I'm also having uh night sweats.",
"speaker": "Patient"
},
{
"start": 168.89448,
"end": 169.72154,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 175.48845,
"end": 176.93958,
"text": "Night first, OK.",
"speaker": "Doctor"
},
{
"start": 175.84236,
"end": 185.73448,
"text": "That's, that's very odd actually. makes me a bit tired, um makes my uneasy.",
"speaker": "Patient"
},
{
"start": 181.56363,
"end": 184.16514,
"text": "Mm. ",
"speaker": "Doctor"
},
{
"start": 185.9095,
"end": 190.78167,
"text": "I can imagine, yes. Uh and this has again, been going on for last uh three four days, has it?",
"speaker": "Doctor"
},
{
"start": 190.69853,
"end": 191.87838,
"text": "Yeah, yes.",
"speaker": "Patient"
},
{
"start": 192.02979,
"end": 197.47339,
"text": "OK. Um right, OK. Have you noticed any fevers or temperatures at all?",
"speaker": "Doctor"
},
{
"start": 198.59783,
"end": 211.79385,
"text": "Um I I had some some fever in the beginning, but it's now sort of uh going down. I I've been taking some Paracetamol and Ibuprofen for that, and uh they, they help.",
"speaker": "Patient"
},
{
"start": 208.79668,
"end": 209.59367,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 212.0072,
"end": 221.1726,
"text": "That's very sensible. Um very good. Um in terms of your chest otherwise, have you any difficulty breathing, or any pain in your chest?",
"speaker": "Doctor"
},
{
"start": 221.33174,
"end": 237.87857,
"text": "Um so no pain in chest, but uh I noticed that I um um so I feel a bit winded on exertion. So if I I I haven't been going, going to the gym thus uh, because of that.",
"speaker": "Patient"
},
{
"start": 238.37557,
"end": 249.65375,
"text": "When you say winded, do you feel, uh do you feel more short of breath would you say, on exertion? Is that when you, OK. Um and and that's mainly on exercise. But when you're resting, there's no problem.",
"speaker": "Doctor"
},
{
"start": 242.61959,
"end": 245.56205,
"text": " yeah. ",
"speaker": "Patient"
},
{
"start": 250.81387,
"end": 257.72762,
"text": "Yeah, yeah. When when when I'm resting it's OK. So I've been actually going to work, um sort of managing.",
"speaker": "Patient"
},
{
"start": 256.1199,
"end": 263.30035,
"text": "OK. OK, fine. Just a couple other questions , if you don't mind. Any pain in, in your ears at all?",
"speaker": "Doctor"
},
{
"start": 264.41823,
"end": 266.5909,
"text": "Um no.",
"speaker": "Patient"
},
{
"start": 266.79658,
"end": 269.66876,
"text": "No, you don't feel blocked, or any discharge coming out of your ears?",
"speaker": "Doctor"
},
{
"start": 268.10169,
"end": 268.59701,
"text": "",
"speaker": "Patient"
},
{
"start": 271.95062,
"end": 273.16543,
"text": "No, I don't think so.",
"speaker": "Patient"
},
{
"start": 273.08229,
"end": 282.60107,
"text": "OK, fine. Um what I'm gonna do, I'm just gonna run through a few uh yes no questions, if you if you don't mind, just a review of your systems. Any, any headaches at all?",
"speaker": "Doctor"
},
{
"start": 284.10894,
"end": 289.19262,
"text": "Um, yeah, yeah. That that's still, that's still there.",
"speaker": "Patient"
},
{
"start": 289.28527,
"end": 291.36045,
"text": "Whereabouts are the head, headaches?",
"speaker": "Doctor"
},
{
"start": 291.90753,
"end": 301.33922,
"text": "Um it's sort of general. Uh and uh they're not, they're not always there, but you know every now and then they will come and go.",
"speaker": "Patient"
},
{
"start": 301.43562,
"end": 305.9093,
"text": "OK. And with those headaches have you had any problems with your, with your eyesight, your vision?",
"speaker": "Doctor"
},
{
"start": 307.22413,
"end": 308.4024,
"text": "Um no.",
"speaker": "Patient"
},
{
"start": 308.69125,
"end": 311.82658,
"text": "Uh any difficulty with seeing bright lights?",
"speaker": "Doctor"
},
{
"start": 313.06588,
"end": 314.87883,
"text": "No, I don't think so.",
"speaker": "Patient"
},
{
"start": 314.45816,
"end": 321.28522,
"text": "No, OK. Um and just moving down now, in terms of any, any feeling nausea or any vomiting?",
"speaker": "Doctor"
},
{
"start": 322.0803,
"end": 323.21699,
"text": "No, none of that.",
"speaker": "Patient"
},
{
"start": 323.7589,
"end": 326.54085,
"text": "OK. Tell me about your bowels. Are your bowels working OK?",
"speaker": "Doctor"
},
{
"start": 327.54794,
"end": 330.08032,
"text": "Uh yeah, yeah. Think so.",
"speaker": "Patient"
},
{
"start": 330.17242,
"end": 331.60099,
"text": "You're passing urine OK?",
"speaker": "Doctor"
},
{
"start": 332.56953,
"end": 334.04436,
"text": "Yeah, yeah.",
"speaker": "Patient"
},
{
"start": 334.32279,
"end": 335.61603,
"text": "How's your appetite, sir?",
"speaker": "Doctor"
},
{
"start": 335.79256,
"end": 343.92209,
"text": "Yeah I've been, I've been drinking a lot more than the usual. But uh so other than that, so ",
"speaker": "Patient"
},
{
"start": 341.80399,
"end": 346.6912,
"text": "OK. Um and you're eating and drinking, uh you're eating OK otherwise.",
"speaker": "Doctor"
},
{
"start": 347.05159,
"end": 352.08045,
"text": "Um maybe a bit less than uh than what I, I would usually have.",
"speaker": "Patient"
},
{
"start": 352.14983,
"end": 357.11223,
"text": "OK. Um have you noticed any, any funny rashes at all, on your skin?",
"speaker": "Doctor"
},
{
"start": 357.79264,
"end": 359.36824,
"text": "Um no, no.",
"speaker": "Patient"
},
{
"start": 359.20997,
"end": 365.16485,
"text": "No. And any general muscle pain or aches, joint pain, ?",
"speaker": "Doctor"
},
{
"start": 364.21909,
"end": 368.26934,
"text": "Yeah, yeah. Yeah that's, that sort of started in the past couple days.",
"speaker": "Patient"
},
{
"start": 368.14981,
"end": 376.3904,
"text": "Yeah, OK. Alright um and uh just having a look at the rest of your history, are you otherwise fit and well? Or do you have any other medical problems I should be aware of?",
"speaker": "Doctor"
},
{
"start": 377.3538,
"end": 387.19677,
"text": "Um, so otherwise that, uh, I'm I'm fine. There's um, there isn't anything that I'm taking or, I'm being treated for.",
"speaker": "Patient"
},
{
"start": 387.17985,
"end": 389.40541,
"text": "OK. Um",
"speaker": "Doctor"
},
{
"start": 388.76397,
"end": 389.26598,
"text": "Um",
"speaker": "Patient"
},
{
"start": 390.03699,
"end": 395.38285,
"text": "So you are otherwise fit and well. Uh any, any allergies at all to any medications, I should be aware of?",
"speaker": "Doctor"
},
{
"start": 396.18126,
"end": 398.44026,
"text": "Um, no ",
"speaker": "Patient"
},
{
"start": 398.08961,
"end": 407.79637,
"text": "No, OK. Um Any family history at all? So anything relevant in the family that I should be aware of? Anything like diabetes, high blood pressure?",
"speaker": "Doctor"
},
{
"start": 408.51925,
"end": 415.51844,
"text": "Um, yeah my grandma has diabetes. Um, and, my grandma.",
"speaker": "Patient"
},
{
"start": 409.16479,
"end": 409.93922,
"text": "",
"speaker": "Doctor"
},
{
"start": 412.83396,
"end": 413.69862,
"text": "Your brother?",
"speaker": "Doctor"
},
{
"start": 415.42794,
"end": 423.08206,
"text": " you say grandma, sorry my apologies. Grandma, OK. Uh do you know what type of diabetes it is? Is it type one, type two?",
"speaker": "Doctor"
},
{
"start": 417.30364,
"end": 419.62019,
"text": "",
"speaker": "Patient"
},
{
"start": 422.08496,
"end": 424.60919,
"text": "I think , I think it's type two.",
"speaker": "Patient"
},
{
"start": 424.59334,
"end": 428.54071,
"text": "OK. Um anything else which you think is significant?",
"speaker": "Doctor"
},
{
"start": 429.13821,
"end": 435.38073,
"text": "Yeah, I, I think um, one of my uh, great grandads had an eczema.",
"speaker": "Patient"
},
{
"start": 435.72114,
"end": 444.18729,
"text": "Excellent, OK. OK. Um just moving on to what we social history, just to get to know you a bit more as a person. Tell me, who do you live with at home?",
"speaker": "Doctor"
},
{
"start": 445.59921,
"end": 447.52021,
"text": "Ohh um, I live alone.",
"speaker": "Patient"
},
{
"start": 447.73616,
"end": 451.0745,
"text": "OK. And you said you're working at the moment?",
"speaker": "Doctor"
},
{
"start": 451.498,
"end": 452.72102,
"text": "Yeah, yeah.",
"speaker": "Patient"
},
{
"start": 452.63841,
"end": 453.72864,
"text": "What do you do for work?",
"speaker": "Doctor"
},
{
"start": 455.01599,
"end": 458.24622,
"text": "I'm an, I'm an accountant.",
"speaker": "Patient"
},
{
"start": 458.53314,
"end": 462.85644,
"text": "OK, and how's your work going at the moment? Uh over the last, has it, has it been affecting your work?",
"speaker": "Doctor"
},
{
"start": 463.6635,
"end": 472.21749,
"text": "Um, a little bit. I've been a bit slower. And you know, it's uh, it's, it's a bit of a stressful period just around the um, end of the year. Right.",
"speaker": "Patient"
},
{
"start": 471.44289,
"end": 477.38273,
"text": "Mm, OK. Is that stress, is that affecting your um, your mood at all any, in any way?",
"speaker": "Doctor"
},
{
"start": 478.21745,
"end": 485.06646,
"text": "Um, no I think I think it's, it's the, you know it's the good kind of stress. It's um, it's good work.",
"speaker": "Patient"
},
{
"start": 483.0519,
"end": 491.64587,
"text": " OK. Well if there's anything you want to talk to me about, you can always come see me about your mood, um stress, anxiety. happy to help.",
"speaker": "Doctor"
},
{
"start": 491.40462,
"end": 496.66687,
"text": "I don't know. I, I like my job. It's just you know, it's a bit more work than usual.",
"speaker": "Patient"
},
{
"start": 495.64586,
"end": 500.91653,
"text": "OK. OK. And just very briefly, just in terms of smoking uh, do you smoke at all?",
"speaker": "Doctor"
},
{
"start": 501.57731,
"end": 506.63488,
"text": "Um, yeah occasionally, you know, cigars and things on company parties.",
"speaker": "Patient"
},
{
"start": 506.57818,
"end": 510.7887,
"text": "OK so not, not regular. Um and what about alcohol?",
"speaker": "Doctor"
},
{
"start": 508.72841,
"end": 509.2464,
"text": "No.",
"speaker": "Patient"
},
{
"start": 511.48381,
"end": 515.87951,
"text": "Um, occasionally yeah I would have some. I'm, I'm not a very big drinker.",
"speaker": "Patient"
},
{
"start": 513.97666,
"end": 517.78117,
"text": " socially with work.",
"speaker": "Doctor"
},
{
"start": 518.98744,
"end": 519.50542,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 518.99922,
"end": 584.39007,
"text": "Um OK. Um so um just having listened to your story, um uh really just to summarize you know since the last four days you've been feeling generally quite unwell, sore throat, runny nose, bit of a dry cough, bit of muscle pain, weakness. Um had initial fever, but now settled. Um I don't think there's a lot to worry about. I think you probably have, you know a bit of a viral, what we say viral illness, maybe a viral upper respiratory tract infection, or maybe early signs of a flu. Um these normally last about seven to days and just gets better really, um over time. But things you can do to really help yourself, um is get plenty of rest. I'd probably advise you taking a day or two off work if you can. Um Making yourself, pushing fluids and make yourself well-hydrated. Continue with the regular Paracetamol, Ibuprofen. Um and and you should see how things go, really. Um if next week you're still not better, I'd like you to come back and see me. Um is that clear? Does that, does that make, does that make ",
"speaker": "Doctor"
},
{
"start": 583.24669,
"end": 592.21076,
"text": "Yeah, yeah, that's that's , it makes sense. Uh, I think I'll take a couple days off, and see how it goes.",
"speaker": "Patient"
},
{
"start": 588.90134,
"end": 604.83364,
"text": "Yeah, yeah. and things to look out for if you're really not getting better, if you if you have a high fever, or your breathing is becoming a bit more labored, or chest pain, I'd like you to come back and see me much sooner, give me a call. Um and we can help you out. OK?",
"speaker": "Doctor"
},
{
"start": 603.03814,
"end": 603.56332,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 605.24677,
"end": 608.32592,
"text": "Yeah, yeah I understand. Uh, I'll uh, I'll take care.",
"speaker": "Patient"
},
{
"start": 608.34492,
"end": 613.67574,
"text": "Great. Have a great day. Good luck with your work. Thank you. Bye bye. Bye bye.",
"speaker": "Doctor"
},
{
"start": 610.74319,
"end": 613.84125,
"text": "Thank you. Thank you. You too. Bye bye.",
"speaker": "Patient"
}
],
"doctor_utterances": "Alex. Ohh. Hello? Hi, can you hear me? OK great. Um how can I help you this morning, sir? Mm-hmm. OK. Sorry to hear that . Mm. OK. I'm sorry to hear that. Seems like there's a lot going on there. Um so let's start with your, your sore throat first. Um tell me a bit more about that, if you can. OK. OK. OK. And did you have any uh difficulty or pain on swallowing? OK. You , did you manage to have a look at the back of your throat in the mirror? No. OK you didn't, you didn't notice any abnormal white spots, redness at the back of your throat? that's OK. That's OK. And you mentioned a runny nose. Um again what kind of discharge is coming out? Is it clear, or is it a bit more coloured? OK. You feel quite congested, do you? OK, fine. Um you also mentioned a cough as well. Can you tell me a bit more about that? OK. OK. And is it worse any particular time of the day? Is it, is it worse any particular time of the day? For example in the evenings, night time, mornings? throughout the day. OK. Night first, OK. Mm. I can imagine, yes. Uh and this has again, been going on for last uh three four days, has it? OK. Um right, OK. Have you noticed any fevers or temperatures at all? OK. That's very sensible. Um very good. Um in terms of your chest otherwise, have you any difficulty breathing, or any pain in your chest? When you say winded, do you feel, uh do you feel more short of breath would you say, on exertion? Is that when you, OK. Um and and that's mainly on exercise. But when you're resting, there's no problem. OK. OK, fine. Just a couple other questions , if you don't mind. Any pain in, in your ears at all? No, you don't feel blocked, or any discharge coming out of your ears? OK, fine. Um what I'm gonna do, I'm just gonna run through a few uh yes no questions, if you if you don't mind, just a review of your systems. Any, any headaches at all? Whereabouts are the head, headaches? OK. And with those headaches have you had any problems with your, with your eyesight, your vision? Uh any difficulty with seeing bright lights? No, OK. Um and just moving down now, in terms of any, any feeling nausea or any vomiting? OK. Tell me about your bowels. Are your bowels working OK? You're passing urine OK? How's your appetite, sir? OK. Um and you're eating and drinking, uh you're eating OK otherwise. OK. Um have you noticed any, any funny rashes at all, on your skin? No. And any general muscle pain or aches, joint pain, ? Yeah, OK. Alright um and uh just having a look at the rest of your history, are you otherwise fit and well? Or do you have any other medical problems I should be aware of? OK. Um So you are otherwise fit and well. Uh any, any allergies at all to any medications, I should be aware of? No, OK. Um Any family history at all? So anything relevant in the family that I should be aware of? Anything like diabetes, high blood pressure? Your brother? you say grandma, sorry my apologies. Grandma, OK. Uh do you know what type of diabetes it is? Is it type one, type two? OK. Um anything else which you think is significant? Excellent, OK. OK. Um just moving on to what we social history, just to get to know you a bit more as a person. Tell me, who do you live with at home? OK. And you said you're working at the moment? What do you do for work? OK, and how's your work going at the moment? Uh over the last, has it, has it been affecting your work? Mm, OK. Is that stress, is that affecting your um, your mood at all any, in any way? OK. Well if there's anything you want to talk to me about, you can always come see me about your mood, um stress, anxiety. happy to help. OK. OK. And just very briefly, just in terms of smoking uh, do you smoke at all? OK so not, not regular. Um and what about alcohol? socially with work. Um OK. Um so um just having listened to your story, um uh really just to summarize you know since the last four days you've been feeling generally quite unwell, sore throat, runny nose, bit of a dry cough, bit of muscle pain, weakness. Um had initial fever, but now settled. Um I don't think there's a lot to worry about. I think you probably have, you know a bit of a viral, what we say viral illness, maybe a viral upper respiratory tract infection, or maybe early signs of a flu. Um these normally last about seven to days and just gets better really, um over time. But things you can do to really help yourself, um is get plenty of rest. I'd probably advise you taking a day or two off work if you can. Um Making yourself, pushing fluids and make yourself well-hydrated. Continue with the regular Paracetamol, Ibuprofen. Um and and you should see how things go, really. Um if next week you're still not better, I'd like you to come back and see me. Um is that clear? Does that, does that make, does that make Yeah, yeah. and things to look out for if you're really not getting better, if you if you have a high fever, or your breathing is becoming a bit more labored, or chest pain, I'd like you to come back and see me much sooner, give me a call. Um and we can help you out. OK? Great. Have a great day. Good luck with your work. Thank you. Bye bye. Bye bye.",
"patient_utterances": " Yeah. Alright, so I've been feeling, I've been feeling kind of uh under the weather for the past four days. Um it started with the um, uh sore throat and runny nose, and It's sort of, um, it's sort of going into a cough now. Um, the sort throat is kind of going away, but, um, I'm starting to cough. And uh kind of uh bad and tired. Um ,so I, I , you know I think I, it all started with, uh, this colleague of mine, she just kept sneezing next to me, all the time. I think her kids are catching something from the uh from their kindergarten or something. And uh, you know the it it started as normal sore throat, and uh was quite painful for a couple days, but then it was past. Um yeah. Yeah it was uh, it was quite painful to swallow, for one or two days. Um no, not really. Um No. Um I I didn't think about uh . Yeah yeah, it's uh it's clearing up . Sort of um, sort of getting my nose stuffed all the time. It's very had to, uh to get it free. Yeah, quite congested. Um yeah that started recently, like just uh um maybe yesterday. And um it's uh, it's dry for now, it's it's not very painful but it's sort of there, all the time. Sorry? Um No it's it's um, it's sort of, it's sort of constant. Um I forgot to mention, that um I'm also having uh night sweats. That's, that's very odd actually. makes me a bit tired, um makes my uneasy. Yeah, yes. Um I I had some some fever in the beginning, but it's now sort of uh going down. I I've been taking some Paracetamol and Ibuprofen for that, and uh they, they help. Um so no pain in chest, but uh I noticed that I um um so I feel a bit winded on exertion. So if I I I haven't been going, going to the gym thus uh, because of that. yeah. Yeah, yeah. When when when I'm resting it's OK. So I've been actually going to work, um sort of managing. Um no. No, I don't think so. Um, yeah, yeah. That that's still, that's still there. Um it's sort of general. Uh and uh they're not, they're not always there, but you know every now and then they will come and go. Um no. No, I don't think so. No, none of that. Uh yeah, yeah. Think so. Yeah, yeah. Yeah I've been, I've been drinking a lot more than the usual. But uh so other than that, so Um maybe a bit less than uh than what I, I would usually have. Um no, no. Yeah, yeah. Yeah that's, that sort of started in the past couple days. Um, so otherwise that, uh, I'm I'm fine. There's um, there isn't anything that I'm taking or, I'm being treated for. Um Um, no Um, yeah my grandma has diabetes. Um, and, my grandma. I think , I think it's type two. Yeah, I, I think um, one of my uh, great grandads had an eczema. Ohh um, I live alone. Yeah, yeah. I'm an, I'm an accountant. Um, a little bit. I've been a bit slower. And you know, it's uh, it's, it's a bit of a stressful period just around the um, end of the year. Right. Um, no I think I think it's, it's the, you know it's the good kind of stress. It's um, it's good work. I don't know. I, I like my job. It's just you know, it's a bit more work than usual. Um, yeah occasionally, you know, cigars and things on company parties. No. Um, occasionally yeah I would have some. I'm, I'm not a very big drinker. Yeah. Yeah, yeah, that's that's , it makes sense. Uh, I think I'll take a couple days off, and see how it goes. Yeah. Yeah, yeah I understand. Uh, I'll uh, I'll take care. Thank you. Thank you. You too. Bye bye.",
"num_turns": 115,
"reference_note": "{\"day\": 1, \"consultation\": 4, \"presenting_complaint\": \"I don't feel well, I have a cough and runny nose\", \"note\": \"4/7 hx of generally unwell, mainly sore throat, runny nose, fatigue, myalgia and general joint pain. Sore throat is improving. Also has nasal congestion. Now developed a cough -mainly dry, constant. Night sweats for the past 4/7. Initially had fever, but now settling with paracetamol/ibuprofen. \\nNo chest pain. Feels more SOB on exertion. \\nAssociated headaches - generalized, intermittent. No visual sx/photophobia. No nausea/vomiting. No bowel or urinary sx. Drinking fluids, reduced appetite. No rashes\\n\\nPMH: Nil \\nDH: nil \\nNKDA\\nFH: Grandmother - type 2 diabetes\\nSH: lives alone, works as an accountant. Occasional smoker/etOH. Finding work slightly stressful. No mood sx. \\n\\nImp: viral URTI/influenza \\n\\nPlan:\\n1.\\tConservative mx - rest, push fluids, regular paracetamol/ibuprofen, monitor temp\\n2.\\tReview in 5-7d INB\\n3.\\tDiscussed red flag sx (SOB, chest pain, fevers)- if present, for urgent review with Dr \\n\", \"highlights\": [\"sore throat\", \"fatigue\", \"myalgia\", \"cough\", \"viral URTI/influenza\"]}",
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"dialogue": "[Doctor] Hello?\n[Patient] \n[Doctor] . Good morning, Tim. Um, how can I help you this morning?\n[Patient] Um, so I'm Having some, some pain, uh, in my tummy, like the lower part of my tummy. Um and I've just been feeling, quite, hot and sweaty.\n[Doctor] OK.\n[Doctor] Right, I'm sorry to hear that. When, when did your symptoms all start?\n[Patient] About two days ago.\n[Doctor] OK. And whereabouts in your tummy is the pain, exactly?\n[Patient] Uh, like below my belly button, it's like quite, sore when I press on it.\n[Doctor] OK. Did the pain come on quite suddenly, or was it more gradual?\n[Patient] , it hasn't been, it's more gradual and it's just, it is getting a bit worse now.\n[Doctor] OK, OK. And can you describe the pain to me?\n[Patient] Uh, it's kind of like a, a, I guess a burning pain. Uh, and it's just right there yeah, in that spot, like uh, that's mostly where I'm feeling it. It hasn't spread anywhere else.\n[Doctor] Just in, just below your belly button you uh, mentioned.\n[Patient] Yeah.\n[Doctor] OK. Um, and is the pain constant, or does it come and go?\n[Patient] It's pretty constant, it's like getting worse. Um, it's not like, I , I can still move and walk around. Uh, I mean I'm still kind of functioning, it's just uh, I'm aware of it time.\n[Doctor] \n[Doctor] . Mm-hmm. OK. Um, and with the pain have you noticed any other symptoms, at all? So, for example, let's, let's focus first on your bowels. Are your bowels working OK?\n[Patient] Yeah, I had a bit of constipation, but that's better, now. That was like, since last week.\n[Doctor] OK. So you've got no other symptoms, like diarrhea or loose stools?\n[Patient] No, I'm , I'm, my bowel movements are normal now.\n[Doctor] No.\n[Doctor] OK. And, what about your waterworks? Are you passing urine OK?\n[Patient] Yeah, I'm fine, that's fine, that's. I did notice that I was a little, the urine was a little pink, in colour. But I haven't like, it hasn't really been burning, specifically or hurting when I pee and uh. And I did notice I was going to the, I was peeing more, regularly, but I have been drinking lots of fluids. So I wasn't sure, um, I wasn't sure, um, like you know, if that was related to the pain.\n[Doctor] Mm.\n[Doctor] And when you mentioned pink urine, do you, was there any blood at all in your urine? Or was it difficult to say?\n[Patient] I can't say, I mean maybe.\n[Doctor] OK, alright. But otherwise, it doesn't hurt, uh, or or or sting, when you pass urine?\n[Patient] And I haven't noticed that it really burns or anything like that. Um, just that I'm, peeing more than , more regularly.\n[Doctor] OK.\n[Doctor] OK. Um, OK. And um, moving on to other symptoms, have you noticed any vomiting, or feeling nauseous at all?\n[Patient] Just a little nauseous, um, but no vomiting.\n[Doctor] No vomiting. Any temperatures or fevers?\n[Patient] I haven't , I felt a bit hot and sweaty, but I haven't really measured it, so I can't really say.\n[Doctor] OK, fine. Um, uh, uh, and Kim, have to ask um, uh all all all patients. This this question is about your cycle, if you don't mind me asking. Um, are you currently um, are you currently sexually active?\n[Patient] Yes.\n[Patient] Uh, yeah I've, I have had the same partner, I am, we were last sexually active about four days ago. Um, my last STD screen was normal, which was about six months ago.\n[Doctor] OK. So you've had no other partner since then.\n[Patient] No, the .\n[Doctor] OK. Um, uh, and do you use any contraception at all?\n[Patient] Uh, I'm, on the Implanon. I had the Implanon inserted about a year ago.\n[Doctor] At the moment, OK, fine. Um, are you still having periods?\n[Patient] Yes.\n[Doctor] When was your last period?\n[Patient] Uh, my last period was about, three weeks ago. I mean, two weeks ago.\n[Doctor] Two week scare, OK. So, is there any chance you could be pregnant? I know you've got an implement in there, but is there any chance you could potentially be pregnant? It's something for us to think about \n[Patient] Well, we don't use any other barrier, method so, we just use the , I just have the Implanon and the same partner. Um. Theoretically, if the Implanon, hasn't been working then I could be pregnant, but I don't suspect .\n[Doctor] Yeah, OK. Well it's something for us to think about. Um, uh, maybe worth taking a pregnancy test later on, just to confirm that. Um OK. And, and so, just to summarize so far, if you don't mind, it's really for the last couple of days, it's tummy pain that's really affected you, mainly lower down towards your belly button. It's quite burning, you said. It's getting worse. Um, you noticed some pink urine. Um, but no burning or stinging pain when you pass urine. Your bowels are working OK. You've felt a little bit nauseous, um, and feeling hot and sweaty. Have I got that all right?\n[Patient] Yeah, that sounds, very accurate.\n[Doctor] Is there anything else, perhaps, that you feel like you should share with me at this stage, anything that might be important?\n[Patient] I don't think so, I think I've, you , we've covered everything that's really bothering me.\n[Doctor] Yeah, OK. Um, tell me, tell me a bit more about your um, medical history otherwise. Are you normally fit and well?\n[Patient] Yeah, , well, I haven't had any, surgical, I don't have any surgical history. I don't have any previous, I haven't had any operations before, or, and I'm not on any other medication, I just have the Implanon.\n[Doctor] \n[Doctor] OK. Um, have you had anything like this before in the past? Any similar symptoms?\n[Patient] I've never , I've never had these symptoms before.\n[Doctor] No, OK. Um\n[Doctor] Fine. Um, any other family history I should be aware of? Anything relevant, family, uh related to bowels, maybe related to history?\n[Patient] No, not that , not that I'm aware of, no.\n[Doctor] OK. Alright. Um, and socially, just tell me a bit more about your home situation. Who's at home with you?\n[Patient] Uh, I live in a share house, and with two other, two other room-mates.\n[Doctor] OK. Um, and uh, are you currently working?\n[Patient] Yeah, I currently, I am currently .\n[Doctor] What do you do for work?\n[Patient] I am an accountant.\n[Doctor] OK. Um\n[Doctor] OK. Um, Do you smoke at all, Kim?\n[Patient] No.\n[Doctor] No. And do you drink much in the way of alcohol?\n[Patient] Uh , socially I drink, but uh, I don't think more, more than normal. .\n[Doctor] No, OK.\n[Doctor] OK. Um, just before I go to the examination, I just want to go through just some few screening questions if that's OK, yes or no. Uh, we've, we've covered the majority of them already. Uh, but I just want to make sure I'm not missing anything else.\n[Patient] All right.\n[Doctor] Um, how's your, how's your chest? How's your breathing? Um, any \n[Patient] I don't feel short of breath uh, or, I'm not having any problems, or I don't have a cough or anything that's , worrying me.\n[Doctor] OK. Any uh, funny heartbeats or rhythms, palpitations?\n[Patient] Not that it, no.\n[Doctor] OK. Any headaches? Any problems with your vision?\n[Patient] No.\n[Doctor] No, OK. Alright. Um, Fine, OK. Um, So really just uh, moving on, um, And so based, based on your story really, uh, uh Kim it's, it's it's difficult. it's it's um, you know you've got some tummy pain. You don't exactly know what's causing it. It could be a few different things that could be causing your pain. Could just be a, you know, could just be a urine infection, for example. Could just be something related to your gut. Um, could just be something related to your, you know, a pregnancy-related cause. Um, and so it's probably worth doing some tests initially. to try and rule out um, what's going on here. Um, which I can organize for you today.\n[Patient] OK.\n[Doctor] Um, and basically those tests, we, we'll have a better idea in terms of how we should proceed. But certainly, it if it's been going on for the last couple of days, um, Uh, you know, it's probably maybe worth empirically treating you for a maybe urine infection. And, so it's an \n[Patient] . Yeah, I , can we do that instead of me, going for tests, and then seeing how that goes?\n[Doctor] Yeah, absolutely. So, um I think it's certainly worth, you know covering you with some antibiotics today. Uh, but i still want you to bear in mind, you know, have a pregnancy test done to make sure we're not missing anything else here. And, um, and I want you to kind of really come back and see me in a few days time, if your symptoms are not getting any better, or indeed if they're getting worse. So, things to look out for would be, you know, worsening tummy pain, um, if you're feeling really hot or sweaty, your temperature's not coming down um, vomiting et cetera. Does that make sense?\n[Patient] Yeah, I think I'm happy with that plan.\n[Doctor] OK. Um, you can try just regular painkillers, uh, Paracetamol would be advisable. Um, make sure you drink plenty of fluids. You can try some cranberry juice as well, which uh, can sometimes help with your urine symptoms. Um, take the antibiotics, uh, and give me a call, you know, if you are worried about anything else.\n[Patient] Uh, sure. That sounds great. Thank you very much. Um, should I just collect the script at my pharmacy?\n[Doctor] \n[Doctor] Yeah, if I send it straight to your pharmacy, start the antibiotics today, something called Trimethoprim. Um, you can take two tablets, uh, one tablet twice a day for three days.\n[Patient] OK.\n[Patient] OK, , that sounds great.\n[Doctor] Uh, , let's see how you get on.\n[Patient] OK. Thank you very much.\n[Doctor] Great. All the best!\n[Patient] Bye.\n[Doctor] Bye bye.",
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"text": "OK. Um, just before I go to the examination, I just want to go through just some few screening questions if that's OK, yes or no. Uh, we've, we've covered the majority of them already. Uh, but I just want to make sure I'm not missing anything else.",
"speaker": "Doctor"
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"text": "All right.",
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"text": "I don't feel short of breath uh, or, I'm not having any problems, or I don't have a cough or anything that's , worrying me.",
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{
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"text": " OK. Any uh, funny heartbeats or rhythms, palpitations?",
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"text": "Not that it, no.",
"speaker": "Patient"
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{
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"text": "OK. Any headaches? Any problems with your vision?",
"speaker": "Doctor"
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"text": "No.",
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"text": "No, OK. Alright. Um, Fine, OK. Um, So really just uh, moving on, um, And so based, based on your story really, uh, uh Kim it's, it's it's difficult. it's it's um, you know you've got some tummy pain. You don't exactly know what's causing it. It could be a few different things that could be causing your pain. Could just be a, you know, could just be a urine infection, for example. Could just be something related to your gut. Um, could just be something related to your, you know, a pregnancy-related cause. Um, and so it's probably worth doing some tests initially. to try and rule out um, what's going on here. Um, which I can organize for you today.",
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"text": "Um, and basically those tests, we, we'll have a better idea in terms of how we should proceed. But certainly, it if it's been going on for the last couple of days, um, Uh, you know, it's probably maybe worth empirically treating you for a maybe urine infection. And, so it's an ",
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"text": "Yeah, absolutely. So, um I think it's certainly worth, you know covering you with some antibiotics today. Uh, but i still want you to bear in mind, you know, have a pregnancy test done to make sure we're not missing anything else here. And, um, and I want you to kind of really come back and see me in a few days time, if your symptoms are not getting any better, or indeed if they're getting worse. So, things to look out for would be, you know, worsening tummy pain, um, if you're feeling really hot or sweaty, your temperature's not coming down um, vomiting et cetera. Does that make sense?",
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"text": "Yeah, I think I'm happy with that plan.",
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"text": "OK. Um, you can try just regular painkillers, uh, Paracetamol would be advisable. Um, make sure you drink plenty of fluids. You can try some cranberry juice as well, which uh, can sometimes help with your urine symptoms. Um, take the antibiotics, uh, and give me a call, you know, if you are worried about anything else.",
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"text": "Uh, sure. That sounds great. Thank you very much. Um, should I just collect the script at my pharmacy?",
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"text": "Yeah, if I send it straight to your pharmacy, start the antibiotics today, something called Trimethoprim. Um, you can take two tablets, uh, one tablet twice a day for three days.",
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"doctor_utterances": "Hello? . Good morning, Tim. Um, how can I help you this morning? OK. Right, I'm sorry to hear that. When, when did your symptoms all start? OK. And whereabouts in your tummy is the pain, exactly? OK. Did the pain come on quite suddenly, or was it more gradual? OK, OK. And can you describe the pain to me? Just in, just below your belly button you uh, mentioned. OK. Um, and is the pain constant, or does it come and go? . Mm-hmm. OK. Um, and with the pain have you noticed any other symptoms, at all? So, for example, let's, let's focus first on your bowels. Are your bowels working OK? OK. So you've got no other symptoms, like diarrhea or loose stools? No. OK. And, what about your waterworks? Are you passing urine OK? Mm. And when you mentioned pink urine, do you, was there any blood at all in your urine? Or was it difficult to say? OK, alright. But otherwise, it doesn't hurt, uh, or or or sting, when you pass urine? OK. OK. Um, OK. And um, moving on to other symptoms, have you noticed any vomiting, or feeling nauseous at all? No vomiting. Any temperatures or fevers? OK, fine. Um, uh, uh, and Kim, have to ask um, uh all all all patients. This this question is about your cycle, if you don't mind me asking. Um, are you currently um, are you currently sexually active? OK. So you've had no other partner since then. OK. Um, uh, and do you use any contraception at all? At the moment, OK, fine. Um, are you still having periods? When was your last period? Two week scare, OK. So, is there any chance you could be pregnant? I know you've got an implement in there, but is there any chance you could potentially be pregnant? It's something for us to think about Yeah, OK. Well it's something for us to think about. Um, uh, maybe worth taking a pregnancy test later on, just to confirm that. Um OK. And, and so, just to summarize so far, if you don't mind, it's really for the last couple of days, it's tummy pain that's really affected you, mainly lower down towards your belly button. It's quite burning, you said. It's getting worse. Um, you noticed some pink urine. Um, but no burning or stinging pain when you pass urine. Your bowels are working OK. You've felt a little bit nauseous, um, and feeling hot and sweaty. Have I got that all right? Is there anything else, perhaps, that you feel like you should share with me at this stage, anything that might be important? Yeah, OK. Um, tell me, tell me a bit more about your um, medical history otherwise. Are you normally fit and well? OK. Um, have you had anything like this before in the past? Any similar symptoms? No, OK. Um Fine. Um, any other family history I should be aware of? Anything relevant, family, uh related to bowels, maybe related to history? OK. Alright. Um, and socially, just tell me a bit more about your home situation. Who's at home with you? OK. Um, and uh, are you currently working? What do you do for work? OK. Um OK. Um, Do you smoke at all, Kim? No. And do you drink much in the way of alcohol? No, OK. OK. Um, just before I go to the examination, I just want to go through just some few screening questions if that's OK, yes or no. Uh, we've, we've covered the majority of them already. Uh, but I just want to make sure I'm not missing anything else. Um, how's your, how's your chest? How's your breathing? Um, any OK. Any uh, funny heartbeats or rhythms, palpitations? OK. Any headaches? Any problems with your vision? No, OK. Alright. Um, Fine, OK. Um, So really just uh, moving on, um, And so based, based on your story really, uh, uh Kim it's, it's it's difficult. it's it's um, you know you've got some tummy pain. You don't exactly know what's causing it. It could be a few different things that could be causing your pain. Could just be a, you know, could just be a urine infection, for example. Could just be something related to your gut. Um, could just be something related to your, you know, a pregnancy-related cause. Um, and so it's probably worth doing some tests initially. to try and rule out um, what's going on here. Um, which I can organize for you today. Um, and basically those tests, we, we'll have a better idea in terms of how we should proceed. But certainly, it if it's been going on for the last couple of days, um, Uh, you know, it's probably maybe worth empirically treating you for a maybe urine infection. And, so it's an Yeah, absolutely. So, um I think it's certainly worth, you know covering you with some antibiotics today. Uh, but i still want you to bear in mind, you know, have a pregnancy test done to make sure we're not missing anything else here. And, um, and I want you to kind of really come back and see me in a few days time, if your symptoms are not getting any better, or indeed if they're getting worse. So, things to look out for would be, you know, worsening tummy pain, um, if you're feeling really hot or sweaty, your temperature's not coming down um, vomiting et cetera. Does that make sense? OK. Um, you can try just regular painkillers, uh, Paracetamol would be advisable. Um, make sure you drink plenty of fluids. You can try some cranberry juice as well, which uh, can sometimes help with your urine symptoms. Um, take the antibiotics, uh, and give me a call, you know, if you are worried about anything else. Yeah, if I send it straight to your pharmacy, start the antibiotics today, something called Trimethoprim. Um, you can take two tablets, uh, one tablet twice a day for three days. Uh, , let's see how you get on. Great. All the best! Bye bye.",
"patient_utterances": " Um, so I'm Having some, some pain, uh, in my tummy, like the lower part of my tummy. Um and I've just been feeling, quite, hot and sweaty. About two days ago. Uh, like below my belly button, it's like quite, sore when I press on it. , it hasn't been, it's more gradual and it's just, it is getting a bit worse now. Uh, it's kind of like a, a, I guess a burning pain. Uh, and it's just right there yeah, in that spot, like uh, that's mostly where I'm feeling it. It hasn't spread anywhere else. Yeah. It's pretty constant, it's like getting worse. Um, it's not like, I , I can still move and walk around. Uh, I mean I'm still kind of functioning, it's just uh, I'm aware of it time. Yeah, I had a bit of constipation, but that's better, now. That was like, since last week. No, I'm , I'm, my bowel movements are normal now. Yeah, I'm fine, that's fine, that's. I did notice that I was a little, the urine was a little pink, in colour. But I haven't like, it hasn't really been burning, specifically or hurting when I pee and uh. And I did notice I was going to the, I was peeing more, regularly, but I have been drinking lots of fluids. So I wasn't sure, um, I wasn't sure, um, like you know, if that was related to the pain. I can't say, I mean maybe. And I haven't noticed that it really burns or anything like that. Um, just that I'm, peeing more than , more regularly. Just a little nauseous, um, but no vomiting. I haven't , I felt a bit hot and sweaty, but I haven't really measured it, so I can't really say. Yes. Uh, yeah I've, I have had the same partner, I am, we were last sexually active about four days ago. Um, my last STD screen was normal, which was about six months ago. No, the . Uh, I'm, on the Implanon. I had the Implanon inserted about a year ago. Yes. Uh, my last period was about, three weeks ago. I mean, two weeks ago. Well, we don't use any other barrier, method so, we just use the , I just have the Implanon and the same partner. Um. Theoretically, if the Implanon, hasn't been working then I could be pregnant, but I don't suspect . Yeah, that sounds, very accurate. I don't think so, I think I've, you , we've covered everything that's really bothering me. Yeah, , well, I haven't had any, surgical, I don't have any surgical history. I don't have any previous, I haven't had any operations before, or, and I'm not on any other medication, I just have the Implanon. I've never , I've never had these symptoms before. No, not that , not that I'm aware of, no. Uh, I live in a share house, and with two other, two other room-mates. Yeah, I currently, I am currently . I am an accountant. No. Uh , socially I drink, but uh, I don't think more, more than normal. . All right. I don't feel short of breath uh, or, I'm not having any problems, or I don't have a cough or anything that's , worrying me. Not that it, no. No. OK. . Yeah, I , can we do that instead of me, going for tests, and then seeing how that goes? Yeah, I think I'm happy with that plan. Uh, sure. That sounds great. Thank you very much. Um, should I just collect the script at my pharmacy? OK. OK, , that sounds great. OK. Thank you very much. Bye.",
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"reference_note": "{\"day\": 1, \"consultation\": 5, \"presenting_complaint\": \"Lower abdominal pain\", \"note\": \"2/7 ago developed lower abdo pain/suprapubic pain, gradual onset, burning pain, constant, progressively worsening\\nNo bowel sx. \\nUrinary sx - noticed some pink coloured urine, no frank haematuria, nil dysuria. \\nSome nausea, no vomiting\\nFeeling hot and sweaty\\nCurrently sexually active with regular partner. Last STD 6/12 ago. Unprotected SI 2/7 ago. \\nLMP 2/52 ago \\n\\nNo chest pain/SOB/palpitations\\nNo headches/visual sx\\n\\nPMH: nil\\nPSH: nil \\nDH: implanon , otherwise nil\\nFH: nil \\nSH: roomshare with 2 flatmates, works as an accountant. Nil smoking, social EtOH \\n\\nImp: ?UTI. also need to exclude pregnancy \\n\\nPlan:\\n1.\\tPregnancy test\\n2.\\tUrine dip and MSU\\n3.\\tRx empirically with Abx for UTI\\n4.\\tRegular paracetamol for pain \\n5.\\tReview in 24-48 hours if sx not improving, or earlier if worsening sx (fever, abdo pain, vomiting)\\n\", \"highlights\": [\"abdo pain/suprapubic pain\", \"burning\", \"Feeling hot and sweaty\", \"UTI\", \"Abx\"]}",
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"dialogue": "[Doctor] Hello?\n[Patient] Hello there.\n[Doctor] Uh, hello. Can you hear me OK?\n[Patient] Yes, I can hear you.\n[Doctor] OK, great. . I am, yes. Nice to see you here, Oscar. Um, how can I help you this afternoon?\n[Patient] Are you the doctor?\n[Patient] Um, I'm, contacting you because I've been, quite short of breath lately.\n[Doctor] OK. Do you want to tell me a bit more about it? When did it all start?\n[Patient] Uh, well it seems to have been, slowly getting worse over the last couple of weeks. Um, now it's, become quite troublesome, in the last few days. Uh, I kind of, normally I can walk to the shops, without a problem but, now I'm having to sort of sit down and catch my breath. And I'm really starting to get a bit breathless, just about the house.\n[Doctor] \n[Patient] And uh, it's got me kind of worried, don't really know what's going on.\n[Doctor] OK.\n[Doctor] OK. OK. Is there anything you're particularly worried about?\n[Patient] Um, well, I've, I've uh, I've got um, heart failure.\n[Doctor] OK.\n[Patient] Uh, I was told that, uh, a while ago. Um, and I got a bit breathless when I was first diagnosed, and put on some medicine that, that um, that helped, but I'm a bit worried it's just getting worse.\n[Doctor] OK.\n[Doctor] Right.\n[Doctor] Right, OK. So you mentioned you're feeling, uh, short of breath for the last couple of weeks, but mainly the last couple of days it's got a bit worse. Um, uh, and you're now feeling more breathless on kind of minimal, minimal exertion you mentioned. Um, have you noticed any other symptoms at all, uh, uh, with your breath? So, for example, any pain in your chest?\n[Patient] No pain in my chest.\n[Doctor] OK. And have you found yourself coughing, coughing at all?\n[Patient] Um.\n[Patient] Uh, I've got a bit of a dry cough, but it's not too troublesome.\n[Doctor] OK. OK. And how's your general health otherwise? Are you feeling uh, weak, lethargic?\n[Patient] Um, I'm feeling a little run-down, um, but otherwise, otherwise pretty normal.\n[Doctor] OK.\n[Patient] I've noticed my ankles have got a bit bigger.\n[Doctor] OK. And what do you mean by that?\n[Patient] Uh, it's just like, it's sort of swollen up a bit.\n[Doctor] OK. Um, is that, is that both ?\n[Patient] Kind of . Um, yeah, both ankles. Yeah, it's a bit embarrassing.\n[Doctor] Both ankles?\n[Doctor] OK. Uh, I can imagine, yeah. Um, and again, over how long has this, have you noticed this for?\n[Patient] Um, I kind of noticed it the last few days.\n[Doctor] Past few days, OK. And is this something that you've had before, in the past?\n[Patient] Uh, I think my ankles did swell up a bit last time, the heart failure was a problem.\n[Doctor] OK. OK. Um, fine. OK. So, um, just to really recap, uh, so you're really, in the last couple of weeks, uh, you've been feeling breathless, uh, but worse in the last couple of days. You mentioned you had a bit of a dry cough. Um, and some swelling in your ankles. Um, reporting no chest pain. Um, and, and have you had any, have you any, have you noticed your heartbeat racing at all? So, palpitations or skipped heartbeat?\n[Patient] No, not really.\n[Doctor] OK. And any temperatures or fevers?\n[Patient] Uh, no.\n[Doctor] OK. And how about your appetite? Are you eating and drinking OK?\n[Patient] Yeah, I, , I'm, that's fine.\n[Doctor] OK. And your waterworks? Are you passing urine OK?\n[Patient] Uh, yeah, but yeah. I usually pee a lot, , ever since the drugs .\n[Doctor] Yeah. Sure, OK. Alright. Um, fine. So, your uh, your past medical history. You mentioned heart failure. Any, any other medical history I should be aware of?\n[Patient] Uh, well I was told I had like a, they called it like a small heart attack. About, five years ago. Um, I uh, I had, I, I had like some chest pain and, they took me into hospital.\n[Doctor] OK.\n[Patient] And um, they, uh, but then I just got better.\n[Doctor] OK. And when, when you say a small heart attack, did they give you a name, for what happened, a, a name of a diagnosis?\n[Patient] Um.\n[Patient] Uh, I can't remember. They just called it something a , uh, something like that, a small heart attack.\n[Doctor] It's more hard to say. OK. Was it like angina or, um,\n[Patient] Um.\n[Patient] Uh, no they, they said that it, uh, it seemed, it was like, more than angina.\n[Doctor] OK.\n[Patient] Um, uh, but um, I didn't, but I only had to stay in hospital for a few days, and, uh.\n[Doctor] OK.\n[Doctor] OK.\n[Patient] And yeah, I've been OK since then.\n[Doctor] You've been OK since then. OK, alright. So, apart from the uh, the heart, the heart problems, the heart failure, any other problems I should be aware of?\n[Patient] Uh, no, I think I'm otherwise, I'm OK.\n[Doctor] OK. Um, do you take any regular medications, apart from your diuretics that you're taking? And do you know which ones?\n[Patient] Uh, yeah, I take something called Furosemide.\n[Doctor] . Do you know which dose you're taking?\n[Patient] I can't remember, I'm sorry doctor. I have to check.\n[Doctor] That's OK. No problems. Um, Any other medications?\n[Patient] Uh, yeah. I take Aspirin.\n[Doctor] OK.\n[Patient] And uh, Bisoprolol.\n[Doctor] The Metoprolol, was it? Or?\n[Patient] Uh, Bisoprolol.\n[Doctor] Sorry, the connection's not very good. OK. Thank you, yeah.\n[Doctor] \n[Patient] Um, .\n[Doctor] And a thousand, OK. Alright. Any allergies at all? Any medications?\n[Patient] Uh, no, no allergies.\n[Doctor] No. OK. And is there anything in the family that's, uh, that, that's uh, that's important for me to know? Any family history of medical problems, heart problems, lung problems?\n[Patient] Uh , my, my father died of a, uh, of a heart attack.\n[Doctor] I'm sorry to hear that. And, um, how old was your father when he passed away?\n[Patient] Uh, he was, um, early sixties.\n[Doctor] Early sixties, OK. Alright. Anything else I should be aware of?\n[Patient] Um, my mother had osteoporosis.\n[Doctor] OK. Is your mother still with us?\n[Patient] Uh, yeah, she's still living.\n[Doctor] OK, alright. Um, and socially, sir, just tell me a bit more about your situation at home. Who lives at home with you?\n[Patient] Uh, I live on my own. Well, I got two cats.\n[Doctor] You've got two cats. OK, great. Do they have names?\n[Patient] They're my family. Uh, they're, they're called, um, they're called, Polly and Tim.\n[Doctor] OK. Um, so it's just you and your cats. And um, in terms of day to day, are you working at the moment?\n[Patient] Uh, I work part-time as, a, uh, lorry driver.\n[Doctor] OK. And how is that? Is that quite stressful, long hours?\n[Patient] Uh, it's OK. Um, I uh, yeah , when I'm working it's pretty exhausting.\n[Doctor] Mm.\n[Patient] Um, I guess I'm a bit worried, that if I get sick I won't, if I get more sick then, I won't be able to work properly.\n[Doctor] Yeah, that's certainly a consideration, isn't it? So let's, let's try and get you better soon, so it doesn't have any um, impact on your, on your job.\n[Patient] No.\n[Doctor] Uh, and do you find yourself doing a lot of anti-social hours? Do you , do you do a lot of night driving, weekend driving? \n[Patient] Ohh no, I , I , I, I only take shifts during the day, I don't like working at night.\n[Doctor] OK. OK, alright. And what about smoking and alcohol? So, 'cause that can sometimes be very important when it comes to heart problems. Do you, do you smoke at all?\n[Patient] Not any more.\n[Doctor] So, you used to smoke?\n[Patient] Yeah.\n[Doctor] And how many did you smoke a day, on average?\n[Patient] Ooh it was about, about a pack a day, back in the day.\n[Doctor] Um, and how many, how many years was that for?\n[Patient] Ohh that was, oof, good twenty five years.\n[Doctor] OK. And what about the stopping? That must have been difficult for you. stopping. Um, and what, what about alcohol?\n[Patient] I don't drink alcohol.\n[Doctor] OK. Do you do much in the way of exercise, sir?\n[Patient] Uh, I try and walk to the shops, at least once a day.\n[Doctor] OK.\n[Patient] Um, but uh, that's about it, I've. Yeah, I don't, I don't go running like I used to when i was young.\n[Doctor] OK.\n[Doctor] Right, OK. And certainly now your symptoms, you, you're, you said you're feeling more breathless even walking to the uh, to the shop, she said. Um, right. Ohh um, based on your, based on you history, and having listened to your story, I, I wonder whether you've had a flare-up of your heart failure, sir. Um, Which can sometimes happen. Um, um, and uh,\n[Patient] Mmm. That.\n[Doctor] It's . So, it seems like your heart's not pumping as well as it should be. Um, and obviously having diagnosed with heart failure, there's obviously\n[Patient] What's going on.\n[Doctor] Um, that's the first thing that comes to my mind. Um, now there's a couple of options move forward. Um,\n[Patient] Mmm.\n[Doctor] Given that you're otherwise well at the moment, and having examined you, your chest, and your saturations and blood pressure are all OK, I'm quite happy to increase your dose of Furosemide. Maybe, rather than one tablet a day, we can do two tablets a day, for the first few days. Um, and see, and see how you're getting on.\n[Patient] OK. If you think that'll be better.\n[Doctor] Uh, I think, I think, it's, it's, it's definitely worth treating your symptoms. But what we should also think about is maybe doing a couple of other tests, like a blood test, and maybe an echocardiogram of your heart, to see how well your heart's pumping.\n[Patient] OK.\n[Doctor] Is that something you've had before? Yeah, so um, an , it's a, it's a general scan of your heart. You might have had this done before, when you were diagnosed. And it's just to get a good\n[Patient] What does that?\n[Patient] Ohh yes, I remember now.\n[Doctor] Sorry?\n[Patient] Uh, yeah, I remember now. .\n[Doctor] You remember that. OK, fine. That's something I can organize for you today. And, and that might take a week or two weeks for that to be organized. But, I think certainly in the meantime, let's, um, Let's, let's get a blood test done. We can check your um, you know your full blood count, look for signs of anemia. We can have a check of your kidney function. Um, and we can definitely increase your um, your Furosemide, uh, to you know, one tablet twice a day. But I really like, would like you to come back and see me in about a week's time, see how you're getting on. That sound reasonable?\n[Patient] I think that sounds like a good plan.\n[Doctor] And of course, in the meantime if you are getting more unwell, feel like you're getting more breathless, or you're having any other symptoms like chest pain, or palpitations or dizziness, then, uh, you know I want you to give me a call sooner than that, and we can have a chat on the phone as well.\n[Patient] OK. I'll see how I get on.\n[Doctor] OK? Do you have any questions for me?\n[Patient] Uh, I think that's all pretty clear. Thank you very much Doctor.\n[Doctor] Great, and then well I wish you all the best! Have a good day. OK. Thank you.\n[Patient] OK. See you soon.",
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{
"start": 51.44375,
"end": 52.15294,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 55.14737,
"end": 58.13629,
"text": "OK. OK. Is there anything you're particularly worried about?",
"speaker": "Doctor"
},
{
"start": 60.12699,
"end": 67.16879,
"text": "Um, well, I've, I've uh, I've got um, heart failure.",
"speaker": "Patient"
},
{
"start": 66.84291,
"end": 67.71438,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 67.16879,
"end": 81.73894,
"text": "Uh, I was told that, uh, a while ago. Um, and I got a bit breathless when I was first diagnosed, and put on some medicine that, that um, that helped, but I'm a bit worried it's just getting worse.",
"speaker": "Patient"
},
{
"start": 72.65622,
"end": 73.26625,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 75.33206,
"end": 75.9916,
"text": "Right.",
"speaker": "Doctor"
},
{
"start": 79.35911,
"end": 98.76156,
"text": " Right, OK. So you mentioned you're feeling, uh, short of breath for the last couple of weeks, but mainly the last couple of days it's got a bit worse. Um, uh, and you're now feeling more breathless on kind of minimal, minimal exertion you mentioned. Um, have you noticed any other symptoms at all, uh, uh, with your breath? So, for example, any pain in your chest?",
"speaker": "Doctor"
},
{
"start": 100.66643,
"end": 102.0048,
"text": "No pain in my chest.",
"speaker": "Patient"
},
{
"start": 102.13958,
"end": 105.62029,
"text": "OK. And have you found yourself coughing, coughing at all?",
"speaker": "Doctor"
},
{
"start": 104.07804,
"end": 104.64334,
"text": "Um.",
"speaker": "Patient"
},
{
"start": 107.06404,
"end": 110.53598,
"text": "Uh, I've got a bit of a dry cough, but it's not too troublesome.",
"speaker": "Patient"
},
{
"start": 110.53661,
"end": 117.3852,
"text": "OK. OK. And how's your general health otherwise? Are you feeling uh, weak, lethargic?",
"speaker": "Doctor"
},
{
"start": 119.02871,
"end": 125.07787,
"text": "Um, I'm feeling a little run-down, um, but otherwise, otherwise pretty normal.",
"speaker": "Patient"
},
{
"start": 124.97833,
"end": 125.77094,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 125.3143,
"end": 127.1967,
"text": "I've noticed my ankles have got a bit bigger.",
"speaker": "Patient"
},
{
"start": 127.44067,
"end": 129.09519,
"text": "OK. And what do you mean by that?",
"speaker": "Doctor"
},
{
"start": 130.65187,
"end": 134.81223,
"text": "Uh, it's just like, it's sort of swollen up a bit.",
"speaker": "Patient"
},
{
"start": 135.21376,
"end": 137.71019,
"text": "OK. Um, is that, is that both ?",
"speaker": "Doctor"
},
{
"start": 137.23004,
"end": 143.34749,
"text": "Kind of . Um, yeah, both ankles. Yeah, it's a bit embarrassing.",
"speaker": "Patient"
},
{
"start": 138.72937,
"end": 139.7912,
"text": "Both ankles?",
"speaker": "Doctor"
},
{
"start": 143.3403,
"end": 149.34216,
"text": "OK. Uh, I can imagine, yeah. Um, and again, over how long has this, have you noticed this for?",
"speaker": "Doctor"
},
{
"start": 150.53588,
"end": 153.41994,
"text": "Um, I kind of noticed it the last few days.",
"speaker": "Patient"
},
{
"start": 153.38634,
"end": 156.95303,
"text": "Past few days, OK. And is this something that you've had before, in the past?",
"speaker": "Doctor"
},
{
"start": 158.59053,
"end": 165.10107,
"text": "Uh, I think my ankles did swell up a bit last time, the heart failure was a problem.",
"speaker": "Patient"
},
{
"start": 164.91211,
"end": 188.8029,
"text": "OK. OK. Um, fine. OK. So, um, just to really recap, uh, so you're really, in the last couple of weeks, uh, you've been feeling breathless, uh, but worse in the last couple of days. You mentioned you had a bit of a dry cough. Um, and some swelling in your ankles. Um, reporting no chest pain. Um, and, and have you had any, have you any, have you noticed your heartbeat racing at all? So, palpitations or skipped heartbeat?",
"speaker": "Doctor"
},
{
"start": 189.59231,
"end": 191.01405,
"text": "No, not really.",
"speaker": "Patient"
},
{
"start": 190.90742,
"end": 193.2775,
"text": "OK. And any temperatures or fevers?",
"speaker": "Doctor"
},
{
"start": 194.54148,
"end": 195.37719,
"text": "Uh, no.",
"speaker": "Patient"
},
{
"start": 195.45548,
"end": 198.79222,
"text": "OK. And how about your appetite? Are you eating and drinking OK?",
"speaker": "Doctor"
},
{
"start": 199.83826,
"end": 201.6807,
"text": "Yeah, I, , I'm, that's fine.",
"speaker": "Patient"
},
{
"start": 201.74069,
"end": 204.94935,
"text": "OK. And your waterworks? Are you passing urine OK?",
"speaker": "Doctor"
},
{
"start": 206.37634,
"end": 212.50676,
"text": "Uh, yeah, but yeah. I usually pee a lot, , ever since the drugs .",
"speaker": "Patient"
},
{
"start": 209.65125,
"end": 222.59168,
"text": "Yeah. Sure, OK. Alright. Um, fine. So, your uh, your past medical history. You mentioned heart failure. Any, any other medical history I should be aware of?",
"speaker": "Doctor"
},
{
"start": 223.94152,
"end": 236.39453,
"text": "Uh, well I was told I had like a, they called it like a small heart attack. About, five years ago. Um, I uh, I had, I, I had like some chest pain and, they took me into hospital.",
"speaker": "Patient"
},
{
"start": 236.33841,
"end": 237.02774,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 236.89584,
"end": 240.50586,
"text": "And um, they, uh, but then I just got better.",
"speaker": "Patient"
},
{
"start": 240.92337,
"end": 247.34717,
"text": "OK. And when, when you say a small heart attack, did they give you a name, for what happened, a, a name of a diagnosis?",
"speaker": "Doctor"
},
{
"start": 241.79845,
"end": 242.46321,
"text": "Um.",
"speaker": "Patient"
},
{
"start": 248.74342,
"end": 254.98492,
"text": "Uh, I can't remember. They just called it something a , uh, something like that, a small heart attack.",
"speaker": "Patient"
},
{
"start": 254.83827,
"end": 259.24702,
"text": "It's more hard to say. OK. Was it like angina or, um,",
"speaker": "Doctor"
},
{
"start": 259.5493,
"end": 260.08281,
"text": "Um.",
"speaker": "Patient"
},
{
"start": 262.04843,
"end": 265.7762,
"text": "Uh, no they, they said that it, uh, it seemed, it was like, more than angina.",
"speaker": "Patient"
},
{
"start": 265.7452,
"end": 266.52414,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 266.38949,
"end": 275.89917,
"text": "Um, uh, but um, I didn't, but I only had to stay in hospital for a few days, and, uh.",
"speaker": "Patient"
},
{
"start": 274.50751,
"end": 275.33603,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 277.08535,
"end": 277.79437,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 277.33735,
"end": 279.17637,
"text": "And yeah, I've been OK since then.",
"speaker": "Patient"
},
{
"start": 279.05065,
"end": 285.28593,
"text": "You've been OK since then. OK, alright. So, apart from the uh, the heart, the heart problems, the heart failure, any other problems I should be aware of?",
"speaker": "Doctor"
},
{
"start": 286.70948,
"end": 289.41962,
"text": "Uh, no, I think I'm otherwise, I'm OK.",
"speaker": "Patient"
},
{
"start": 289.26053,
"end": 296.29227,
"text": "OK. Um, do you take any regular medications, apart from your diuretics that you're taking? And do you know which ones?",
"speaker": "Doctor"
},
{
"start": 296.01702,
"end": 298.83989,
"text": "Uh, yeah, I take something called Furosemide.",
"speaker": "Patient"
},
{
"start": 299.16188,
"end": 301.01212,
"text": ". Do you know which dose you're taking?",
"speaker": "Doctor"
},
{
"start": 301.91235,
"end": 305.63843,
"text": "I can't remember, I'm sorry doctor. I have to check.",
"speaker": "Patient"
},
{
"start": 304.48156,
"end": 310.03753,
"text": "That's OK. No problems. Um, Any other medications?",
"speaker": "Doctor"
},
{
"start": 311.34711,
"end": 314.40739,
"text": "Uh, yeah. I take Aspirin.",
"speaker": "Patient"
},
{
"start": 314.26421,
"end": 314.88887,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 315.7831,
"end": 317.83985,
"text": "And uh, Bisoprolol.",
"speaker": "Patient"
},
{
"start": 319.18168,
"end": 321.77569,
"text": "The Metoprolol, was it? Or?",
"speaker": "Doctor"
},
{
"start": 321.66159,
"end": 323.19015,
"text": "Uh, Bisoprolol.",
"speaker": "Patient"
},
{
"start": 323.23652,
"end": 325.61275,
"text": "Sorry, the connection's not very good. OK. Thank you, yeah.",
"speaker": "Doctor"
},
{
"start": 327.59884,
"end": 328.04542,
"text": "",
"speaker": "Doctor"
},
{
"start": 327.62244,
"end": 330.17316,
"text": "Um, .",
"speaker": "Patient"
},
{
"start": 330.15647,
"end": 334.92524,
"text": "And a thousand, OK. Alright. Any allergies at all? Any medications?",
"speaker": "Doctor"
},
{
"start": 334.99924,
"end": 337.43402,
"text": "Uh, no, no allergies.",
"speaker": "Patient"
},
{
"start": 335.90842,
"end": 346.03922,
"text": "No. OK. And is there anything in the family that's, uh, that, that's uh, that's important for me to know? Any family history of medical problems, heart problems, lung problems?",
"speaker": "Doctor"
},
{
"start": 347.37602,
"end": 351.63688,
"text": "Uh , my, my father died of a, uh, of a heart attack.",
"speaker": "Patient"
},
{
"start": 351.54958,
"end": 356.22806,
"text": "I'm sorry to hear that. And, um, how old was your father when he passed away?",
"speaker": "Doctor"
},
{
"start": 357.21658,
"end": 360.99918,
"text": "Uh, he was, um, early sixties.",
"speaker": "Patient"
},
{
"start": 360.60552,
"end": 364.43661,
"text": "Early sixties, OK. Alright. Anything else I should be aware of?",
"speaker": "Doctor"
},
{
"start": 365.92671,
"end": 369.24554,
"text": "Um, my mother had osteoporosis.",
"speaker": "Patient"
},
{
"start": 369.09228,
"end": 372.40958,
"text": "OK. Is your mother still with us?",
"speaker": "Doctor"
},
{
"start": 373.89502,
"end": 375.57887,
"text": "Uh, yeah, she's still living.",
"speaker": "Patient"
},
{
"start": 375.6122,
"end": 382.27899,
"text": "OK, alright. Um, and socially, sir, just tell me a bit more about your situation at home. Who lives at home with you?",
"speaker": "Doctor"
},
{
"start": 383.20017,
"end": 387.63764,
"text": "Uh, I live on my own. Well, I got two cats.",
"speaker": "Patient"
},
{
"start": 387.65125,
"end": 390.44021,
"text": "You've got two cats. OK, great. Do they have names?",
"speaker": "Doctor"
},
{
"start": 391.50368,
"end": 399.88316,
"text": "They're my family. Uh, they're, they're called, um, they're called, Polly and Tim.",
"speaker": "Patient"
},
{
"start": 399.68442,
"end": 407.72623,
"text": "OK. Um, so it's just you and your cats. And um, in terms of day to day, are you working at the moment?",
"speaker": "Doctor"
},
{
"start": 409.02807,
"end": 414.72371,
"text": "Uh, I work part-time as, a, uh, lorry driver.",
"speaker": "Patient"
},
{
"start": 415.42778,
"end": 418.78555,
"text": "OK. And how is that? Is that quite stressful, long hours?",
"speaker": "Doctor"
},
{
"start": 419.5063,
"end": 427.44759,
"text": "Uh, it's OK. Um, I uh, yeah , when I'm working it's pretty exhausting.",
"speaker": "Patient"
},
{
"start": 427.34909,
"end": 428.12206,
"text": "Mm.",
"speaker": "Doctor"
},
{
"start": 427.44759,
"end": 433.96662,
"text": "Um, I guess I'm a bit worried, that if I get sick I won't, if I get more sick then, I won't be able to work properly.",
"speaker": "Patient"
},
{
"start": 434.12588,
"end": 442.45237,
"text": "Yeah, that's certainly a consideration, isn't it? So let's, let's try and get you better soon, so it doesn't have any um, impact on your, on your job.",
"speaker": "Doctor"
},
{
"start": 440.56422,
"end": 441.09621,
"text": "No.",
"speaker": "Patient"
},
{
"start": 442.45237,
"end": 450.37919,
"text": "Uh, and do you find yourself doing a lot of anti-social hours? Do you , do you do a lot of night driving, weekend driving? ",
"speaker": "Doctor"
},
{
"start": 449.94506,
"end": 454.92651,
"text": "Ohh no, I , I , I, I only take shifts during the day, I don't like working at night.",
"speaker": "Patient"
},
{
"start": 453.27933,
"end": 461.5624,
"text": "OK. OK, alright. And what about smoking and alcohol? So, 'cause that can sometimes be very important when it comes to heart problems. Do you, do you smoke at all?",
"speaker": "Doctor"
},
{
"start": 463.17101,
"end": 464.18736,
"text": "Not any more.",
"speaker": "Patient"
},
{
"start": 464.41062,
"end": 465.94137,
"text": "So, you used to smoke?",
"speaker": "Doctor"
},
{
"start": 467.36127,
"end": 468.03021,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 467.93582,
"end": 470.11031,
"text": "And how many did you smoke a day, on average?",
"speaker": "Doctor"
},
{
"start": 472.58476,
"end": 476.90256,
"text": "Ooh it was about, about a pack a day, back in the day.",
"speaker": "Patient"
},
{
"start": 476.88757,
"end": 480.13303,
"text": "Um, and how many, how many years was that for?",
"speaker": "Doctor"
},
{
"start": 481.59313,
"end": 485.12935,
"text": "Ohh that was, oof, good twenty five years.",
"speaker": "Patient"
},
{
"start": 485.14758,
"end": 492.22894,
"text": "OK. And what about the stopping? That must have been difficult for you. stopping. Um, and what, what about alcohol?",
"speaker": "Doctor"
},
{
"start": 493.67167,
"end": 494.9989,
"text": "I don't drink alcohol.",
"speaker": "Patient"
},
{
"start": 494.91516,
"end": 497.54315,
"text": "OK. Do you do much in the way of exercise, sir?",
"speaker": "Doctor"
},
{
"start": 499.04237,
"end": 502.96825,
"text": "Uh, I try and walk to the shops, at least once a day.",
"speaker": "Patient"
},
{
"start": 502.94261,
"end": 503.71876,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 503.52118,
"end": 511.50776,
"text": "Um, but uh, that's about it, I've. Yeah, I don't, I don't go running like I used to when i was young.",
"speaker": "Patient"
},
{
"start": 504.5563,
"end": 505.29536,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 511.40004,
"end": 532.98363,
"text": "Right, OK. And certainly now your symptoms, you, you're, you said you're feeling more breathless even walking to the uh, to the shop, she said. Um, right. Ohh um, based on your, based on you history, and having listened to your story, I, I wonder whether you've had a flare-up of your heart failure, sir. Um, Which can sometimes happen. Um, um, and uh,",
"speaker": "Doctor"
},
{
"start": 530.08577,
"end": 532.65706,
"text": "Mmm. That.",
"speaker": "Patient"
},
{
"start": 532.98363,
"end": 541.20454,
"text": "It's . So, it seems like your heart's not pumping as well as it should be. Um, and obviously having diagnosed with heart failure, there's obviously",
"speaker": "Doctor"
},
{
"start": 533.55503,
"end": 534.37561,
"text": "What's going on.",
"speaker": "Patient"
},
{
"start": 541.20454,
"end": 547.636,
"text": "Um, that's the first thing that comes to my mind. Um, now there's a couple of options move forward. Um,",
"speaker": "Doctor"
},
{
"start": 545.10023,
"end": 545.84308,
"text": "Mmm.",
"speaker": "Patient"
},
{
"start": 547.636,
"end": 565.12839,
"text": "Given that you're otherwise well at the moment, and having examined you, your chest, and your saturations and blood pressure are all OK, I'm quite happy to increase your dose of Furosemide. Maybe, rather than one tablet a day, we can do two tablets a day, for the first few days. Um, and see, and see how you're getting on.",
"speaker": "Doctor"
},
{
"start": 566.30142,
"end": 568.17512,
"text": "OK. If you think that'll be better.",
"speaker": "Patient"
},
{
"start": 566.91901,
"end": 580.06464,
"text": "Uh, I think, I think, it's, it's, it's definitely worth treating your symptoms. But what we should also think about is maybe doing a couple of other tests, like a blood test, and maybe an echocardiogram of your heart, to see how well your heart's pumping.",
"speaker": "Doctor"
},
{
"start": 581.27871,
"end": 582.08565,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 582.46829,
"end": 591.36774,
"text": "Is that something you've had before? Yeah, so um, an , it's a, it's a general scan of your heart. You might have had this done before, when you were diagnosed. And it's just to get a good",
"speaker": "Doctor"
},
{
"start": 582.99439,
"end": 583.7668,
"text": "What does that?",
"speaker": "Patient"
},
{
"start": 590.95354,
"end": 592.07616,
"text": "Ohh yes, I remember now.",
"speaker": "Patient"
},
{
"start": 593.04324,
"end": 593.77254,
"text": "Sorry?",
"speaker": "Doctor"
},
{
"start": 594.76762,
"end": 597.36097,
"text": "Uh, yeah, I remember now. .",
"speaker": "Patient"
},
{
"start": 595.80791,
"end": 625.7375,
"text": "You remember that. OK, fine. That's something I can organize for you today. And, and that might take a week or two weeks for that to be organized. But, I think certainly in the meantime, let's, um, Let's, let's get a blood test done. We can check your um, you know your full blood count, look for signs of anemia. We can have a check of your kidney function. Um, and we can definitely increase your um, your Furosemide, uh, to you know, one tablet twice a day. But I really like, would like you to come back and see me in about a week's time, see how you're getting on. That sound reasonable?",
"speaker": "Doctor"
},
{
"start": 626.68295,
"end": 628.02518,
"text": "I think that sounds like a good plan.",
"speaker": "Patient"
},
{
"start": 628.5853,
"end": 642.0411,
"text": "And of course, in the meantime if you are getting more unwell, feel like you're getting more breathless, or you're having any other symptoms like chest pain, or palpitations or dizziness, then, uh, you know I want you to give me a call sooner than that, and we can have a chat on the phone as well.",
"speaker": "Doctor"
},
{
"start": 643.02608,
"end": 645.0855,
"text": "OK. I'll see how I get on.",
"speaker": "Patient"
},
{
"start": 645.34993,
"end": 646.99823,
"text": "OK? Do you have any questions for me?",
"speaker": "Doctor"
},
{
"start": 648.89708,
"end": 652.07099,
"text": "Uh, I think that's all pretty clear. Thank you very much Doctor.",
"speaker": "Patient"
},
{
"start": 651.85868,
"end": 656.98958,
"text": "Great, and then well I wish you all the best! Have a good day. OK. Thank you.",
"speaker": "Doctor"
},
{
"start": 654.25629,
"end": 656.08548,
"text": "OK. See you soon.",
"speaker": "Patient"
}
],
"doctor_utterances": " Hello? Uh, hello. Can you hear me OK? OK, great. . I am, yes. Nice to see you here, Oscar. Um, how can I help you this afternoon? OK. Do you want to tell me a bit more about it? When did it all start? OK. OK. OK. Is there anything you're particularly worried about? OK. OK. Right. Right, OK. So you mentioned you're feeling, uh, short of breath for the last couple of weeks, but mainly the last couple of days it's got a bit worse. Um, uh, and you're now feeling more breathless on kind of minimal, minimal exertion you mentioned. Um, have you noticed any other symptoms at all, uh, uh, with your breath? So, for example, any pain in your chest? OK. And have you found yourself coughing, coughing at all? OK. OK. And how's your general health otherwise? Are you feeling uh, weak, lethargic? OK. OK. And what do you mean by that? OK. Um, is that, is that both ? Both ankles? OK. Uh, I can imagine, yeah. Um, and again, over how long has this, have you noticed this for? Past few days, OK. And is this something that you've had before, in the past? OK. OK. Um, fine. OK. So, um, just to really recap, uh, so you're really, in the last couple of weeks, uh, you've been feeling breathless, uh, but worse in the last couple of days. You mentioned you had a bit of a dry cough. Um, and some swelling in your ankles. Um, reporting no chest pain. Um, and, and have you had any, have you any, have you noticed your heartbeat racing at all? So, palpitations or skipped heartbeat? OK. And any temperatures or fevers? OK. And how about your appetite? Are you eating and drinking OK? OK. And your waterworks? Are you passing urine OK? Yeah. Sure, OK. Alright. Um, fine. So, your uh, your past medical history. You mentioned heart failure. Any, any other medical history I should be aware of? OK. OK. And when, when you say a small heart attack, did they give you a name, for what happened, a, a name of a diagnosis? It's more hard to say. OK. Was it like angina or, um, OK. OK. OK. You've been OK since then. OK, alright. So, apart from the uh, the heart, the heart problems, the heart failure, any other problems I should be aware of? OK. Um, do you take any regular medications, apart from your diuretics that you're taking? And do you know which ones? . Do you know which dose you're taking? That's OK. No problems. Um, Any other medications? OK. The Metoprolol, was it? Or? Sorry, the connection's not very good. OK. Thank you, yeah. And a thousand, OK. Alright. Any allergies at all? Any medications? No. OK. And is there anything in the family that's, uh, that, that's uh, that's important for me to know? Any family history of medical problems, heart problems, lung problems? I'm sorry to hear that. And, um, how old was your father when he passed away? Early sixties, OK. Alright. Anything else I should be aware of? OK. Is your mother still with us? OK, alright. Um, and socially, sir, just tell me a bit more about your situation at home. Who lives at home with you? You've got two cats. OK, great. Do they have names? OK. Um, so it's just you and your cats. And um, in terms of day to day, are you working at the moment? OK. And how is that? Is that quite stressful, long hours? Mm. Yeah, that's certainly a consideration, isn't it? So let's, let's try and get you better soon, so it doesn't have any um, impact on your, on your job. Uh, and do you find yourself doing a lot of anti-social hours? Do you , do you do a lot of night driving, weekend driving? OK. OK, alright. And what about smoking and alcohol? So, 'cause that can sometimes be very important when it comes to heart problems. Do you, do you smoke at all? So, you used to smoke? And how many did you smoke a day, on average? Um, and how many, how many years was that for? OK. And what about the stopping? That must have been difficult for you. stopping. Um, and what, what about alcohol? OK. Do you do much in the way of exercise, sir? OK. OK. Right, OK. And certainly now your symptoms, you, you're, you said you're feeling more breathless even walking to the uh, to the shop, she said. Um, right. Ohh um, based on your, based on you history, and having listened to your story, I, I wonder whether you've had a flare-up of your heart failure, sir. Um, Which can sometimes happen. Um, um, and uh, It's . So, it seems like your heart's not pumping as well as it should be. Um, and obviously having diagnosed with heart failure, there's obviously Um, that's the first thing that comes to my mind. Um, now there's a couple of options move forward. Um, Given that you're otherwise well at the moment, and having examined you, your chest, and your saturations and blood pressure are all OK, I'm quite happy to increase your dose of Furosemide. Maybe, rather than one tablet a day, we can do two tablets a day, for the first few days. Um, and see, and see how you're getting on. Uh, I think, I think, it's, it's, it's definitely worth treating your symptoms. But what we should also think about is maybe doing a couple of other tests, like a blood test, and maybe an echocardiogram of your heart, to see how well your heart's pumping. Is that something you've had before? Yeah, so um, an , it's a, it's a general scan of your heart. You might have had this done before, when you were diagnosed. And it's just to get a good Sorry? You remember that. OK, fine. That's something I can organize for you today. And, and that might take a week or two weeks for that to be organized. But, I think certainly in the meantime, let's, um, Let's, let's get a blood test done. We can check your um, you know your full blood count, look for signs of anemia. We can have a check of your kidney function. Um, and we can definitely increase your um, your Furosemide, uh, to you know, one tablet twice a day. But I really like, would like you to come back and see me in about a week's time, see how you're getting on. That sound reasonable? And of course, in the meantime if you are getting more unwell, feel like you're getting more breathless, or you're having any other symptoms like chest pain, or palpitations or dizziness, then, uh, you know I want you to give me a call sooner than that, and we can have a chat on the phone as well. OK? Do you have any questions for me? Great, and then well I wish you all the best! Have a good day. OK. Thank you.",
"patient_utterances": "Hello there. Yes, I can hear you. Are you the doctor? Um, I'm, contacting you because I've been, quite short of breath lately. Uh, well it seems to have been, slowly getting worse over the last couple of weeks. Um, now it's, become quite troublesome, in the last few days. Uh, I kind of, normally I can walk to the shops, without a problem but, now I'm having to sort of sit down and catch my breath. And I'm really starting to get a bit breathless, just about the house. And uh, it's got me kind of worried, don't really know what's going on. Um, well, I've, I've uh, I've got um, heart failure. Uh, I was told that, uh, a while ago. Um, and I got a bit breathless when I was first diagnosed, and put on some medicine that, that um, that helped, but I'm a bit worried it's just getting worse. No pain in my chest. Um. Uh, I've got a bit of a dry cough, but it's not too troublesome. Um, I'm feeling a little run-down, um, but otherwise, otherwise pretty normal. I've noticed my ankles have got a bit bigger. Uh, it's just like, it's sort of swollen up a bit. Kind of . Um, yeah, both ankles. Yeah, it's a bit embarrassing. Um, I kind of noticed it the last few days. Uh, I think my ankles did swell up a bit last time, the heart failure was a problem. No, not really. Uh, no. Yeah, I, , I'm, that's fine. Uh, yeah, but yeah. I usually pee a lot, , ever since the drugs . Uh, well I was told I had like a, they called it like a small heart attack. About, five years ago. Um, I uh, I had, I, I had like some chest pain and, they took me into hospital. And um, they, uh, but then I just got better. Um. Uh, I can't remember. They just called it something a , uh, something like that, a small heart attack. Um. Uh, no they, they said that it, uh, it seemed, it was like, more than angina. Um, uh, but um, I didn't, but I only had to stay in hospital for a few days, and, uh. And yeah, I've been OK since then. Uh, no, I think I'm otherwise, I'm OK. Uh, yeah, I take something called Furosemide. I can't remember, I'm sorry doctor. I have to check. Uh, yeah. I take Aspirin. And uh, Bisoprolol. Uh, Bisoprolol. Um, . Uh, no, no allergies. Uh , my, my father died of a, uh, of a heart attack. Uh, he was, um, early sixties. Um, my mother had osteoporosis. Uh, yeah, she's still living. Uh, I live on my own. Well, I got two cats. They're my family. Uh, they're, they're called, um, they're called, Polly and Tim. Uh, I work part-time as, a, uh, lorry driver. Uh, it's OK. Um, I uh, yeah , when I'm working it's pretty exhausting. Um, I guess I'm a bit worried, that if I get sick I won't, if I get more sick then, I won't be able to work properly. No. Ohh no, I , I , I, I only take shifts during the day, I don't like working at night. Not any more. Yeah. Ooh it was about, about a pack a day, back in the day. Ohh that was, oof, good twenty five years. I don't drink alcohol. Uh, I try and walk to the shops, at least once a day. Um, but uh, that's about it, I've. Yeah, I don't, I don't go running like I used to when i was young. Mmm. That. What's going on. Mmm. OK. If you think that'll be better. OK. What does that? Ohh yes, I remember now. Uh, yeah, I remember now. . I think that sounds like a good plan. OK. I'll see how I get on. Uh, I think that's all pretty clear. Thank you very much Doctor. OK. See you soon.",
"num_turns": 136,
"reference_note": "{\"day\": 1, \"consultation\": 6, \"presenting_complaint\": \"hard to breathe\", \"note\": \"2/5 hx of SOB, worsening over the past 2/7. Feeling more SOB on minimal exertion, nil SOB at rest. No chest pain/palpitations. Assoc cough - mainly dry. No fevers. Has also noticed ankle odema bilaterally over past few days extending to shins. \\nDiagnosed with heart failure previously and currently on diuretics. \\nUrinary - Polyuria, nil else\\n\\nPMH: Heart failure, ?unstable angina \\nDH: furosemide, aspirin, bisoprolol, simvastatin\\nNKDA\\nFH - father died of MI early 60s , mother - osteoporosis \\nSH: lives alone, 2 cats , works part time as a lorry driver. Ex-smoker - a pack/d for 25 years. No etOH\\n\\nImp: exacerbation of heart failure\\n\\nPlan:\\n1.\\tIncrease furosemide BD\\n2.\\tBlood tests, inc U+Es, FBC, BNP\\n3.\\tArrange echo \\n4.\\tReview in 7d, or earlier if worsening sx (chest pain, SOB, dizziness, etc)\\n\", \"highlights\": [\"2/5 hx of SOB\", \"No chest pain/palpitations\", \"cough\", \"ankle odema bilaterally\", \"Heart failure\", \"exacerbation of heart failure\"]}",
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"consultation_id": "day1_consultation07",
"dialogue": "[Doctor] Hello?\n[Patient] Hello?\n[Doctor] Hello? Uh, can you hear me OK?\n[Patient] Yes, yeah I can, I can, cheers.\n[Doctor] . Great. Right, how can I help you this afternoon sir?\n[Patient] Uh, I am not feeling, very well.\n[Doctor] I'm sorry to.\n[Patient] And I haven't been feeling well, for, a good few days, now, and, I'm really hoping you can do something about it, because it's been, bugging me, for a while now.\n[Doctor] Well I will certainly try my best, for you. Um, can you tell me a bit more about what's been going on?\n[Patient] Uh, I just feel a bit, run-down, you know I've got, a cough, a cold.\n[Doctor] . Mm-hmm.\n[Patient] You know, my wife's been nagging me. I just, it's just all, yeah, it's just, that, that, that's it, that's it.\n[Doctor] Mmm. OK, well let's start with your cough first. Tell me a bit more about your cough. Is it, for example are you, coughing up anything at all, or is it mainly dry?\n[Patient] Uh, yeah, yeah, mean, mostly, dry it's a , you know it's a wee bit in the morning it's a bit worse uh, but , and you know it's, it's fairly, fairly dry, aye.\n[Doctor] \n[Doctor] So you're not bringing up any mucky, flem?\n[Patient] Yeah, yeah, yeah, yeah, yeah, yeah. I don't like to admit that it's, you know it's talk about but, yeah it's , aye, aye. It's a wee bit, wee bit uh, yeah.\n[Doctor] OK, all right.\n[Doctor] Yeah, I can certainly hear you've got the sniffles. So, bit of a runny, bit of a runny nose, you mentioned.\n[Patient] Yeah, yeah, yeah, aye, aye you're right. Is that, is that coming through loud and clear on the phone yeah the, the sniffling, yeah, .\n[Doctor] . Yeah, sorry to hear that, yeah no . Um, and uh, any other symptoms, so for example have you any, uh, any sore throats, any ear pain?\n[Patient] Yeah, ugh, yeah, yeah. I've, I've had a bit of a sore throat. I mean, I, you know, , I'm doing a lot of uh, you know I'm, , watching the, watching the football as well. So I do a lot of shouting at that, but uh, uh, uh, I'm not sure if that's related or not.\n[Doctor] \n[Doctor] Ah OK. Who do you support?\n[Patient] Uh, well it's a team, called, Partick Thistle. And they're in the, they're not even in the top division, uh, of the Scottish, league. They're actually in the, the, the championship, which is the league below that, and they're, bottom of the table.\n[Doctor] Right.\n[Patient] So I've been, shouting myself a wee bit hoarse, 'cause their performance has been, uh, pretty shite, if I'm being honest with you. .\n[Doctor] Well, all sounds fascinating, well I wish them all the best. nothing table. Um, so, so you mentioned sore throat. Um, and have you had a chance to look in the, in the mirror? Have you had a look at the back of your throat?\n[Patient] , yeah, yeah, yeah.\n[Patient] , aye, I mean aye, I, I shave, every day so I'm, I'm looking at myself, it's not, not, not a pretty sight to be honest at the best of times but it's been a, wee bit, a wee bit rough, uh, the last few days for sure.\n[Doctor] Yeah, now, I mean have you any, have you noticed any kind of, white spots on the back of your, back of your throat, or redness?\n[Patient] Ohh right, right aye. , sorry you mean I'm looking ah right yeah uh. , no I, I don't, I don't really like to look, you know to look at it so I, I, I haven't, haven't tried to do any of that.\n[Doctor] .\n[Doctor] .\n[Doctor] . I understand it's not pretty but as I say it's not, it's not something we, we always um, uh, recommend but um, moving on. In terms of your ears , any dullness or blocked ears, pain in your ears.\n[Patient] \n[Patient] Uh, yeah, , a, a wee bit I mean . You know, I'm fit, I'm , I'm fifty years old now and my, my hearing's, you know it's not as good as it used to be but, you know I , I, I think, I think it's all right, it's all right.\n[Doctor] OK, OK. Fine. Um, moving down to your chest. Um, how's your breathing been? So do, you feel more breathless or tight in your chest?\n[Patient] Uh.\n[Patient] Uh, no. No, no it's, it's not. No, no, no, .\n[Doctor] . So your breathing is ?\n[Patient] , sorry, what was that?\n[Doctor] Uh, your, your breathing is fine is it? your, it's not laboured, or?\n[Patient] No it's, it's, it's, it's not, it's not good. It's not good.\n[Doctor] OK. It's not good?\n[Patient] No. No, no.\n[Doctor] No, OK, OK. So you're , you're, you're feeling more short of breath?\n[Patient] Yeah, yeah.\n[Doctor] OK, OK, , OK. Um, any pain in your chest at all?\n[Patient] No, no it's, it's, it's weird, it's, it's just, you know it's just a wee bit, it's just a wee bit shortness of breath, but it's not, , it's, it's not, it's not pain, you know, as such.\n[Doctor] No pain, OK, OK. Have you noticed yourself, any, any, any temperatures or fevers? Um, feeling hot and cold? Sweaty?\n[Patient] Yeah, yeah that's, that's, that's, that's definitely something I've noticed. Like, you know in, in bed with the wife and having to, you know get out and, get the blanket off, and put it back on again it's, it's not, it's not pleasant. I mean, I'm keeping her up at night as well, which is a, bloody nightmare but, I mean, you know how these things are.\n[Doctor] .\n[Doctor] .\n[Doctor] Yeah, .\n[Doctor] Seems, seems very difficult at the moment. Um, , have you measured your temperature at all? Have you, got a ?\n[Patient] \n[Patient] But uh, no I mean, no you know, you know, I can, I just feel it in my forehead but, I mean, I haven't, haven't, you know, used a thermometer or anything.\n[Doctor] Mmm, OK.\n[Doctor] Sure, OK. Um, and just moving on, just very quickly. Um, any other symptoms? Any nausea? Any vomiting? Any tummy pain?\n[Patient] Uh, the, the first, the first day I had, you know a wee bit, of uh, , you know uh, you know the rot like, a wee bit of diarrhoea.\n[Doctor] .\n[Patient] You know but, but that, that's, that's fine, now. Um, and, , yeah but, but apart from that, , no.\n[Doctor] .\n[Doctor] OK. And how's your appetite? Are you eating and drinking OK?\n[Patient] Uh, yeah I mean I'm, I'm, I'm trying to and I think what, what is you , you starve, a cold and you, feed the. I, can't remember what it is, but I think I've, uh, my appetite's been, been all right yeah, yeah. I'm trying to, trying to keep, keep the fluids up as well you know, I hear that's what you should do.\n[Doctor] .\n[Doctor] Yeah, absolutely, , completely uh, recommend that, so keep, keep doing what you're doing. Um, and just lastly, you know any, any, any kind of muscle pain, joint pains?\n[Patient] \n[Patient] Yeah.\n[Patient] Yeah it's, it's, it's just been a wee. I mean again, you know I'm , I'm getting a just a wee bit older now so it, it's, it's not something that I, I was thinking about but, I have, I have noticed like when I, you know, when I'm bending down and. Know moving about, it's just, a wee, a wee bit stiffer than, than normal. , you know and I'm, I think that might be to do with whatever this.\n[Doctor] Mmm.\n[Patient] Thing is, but, again it's, you know, I'm just getting on.\n[Doctor] And where do you, where do you feel the stiffness?\n[Patient] It it's, just kinda, like you know when you're, when you're bending like, elbows and knees and just, just a wee bit, kinda stiff, you know?\n[Doctor] , all over, OK. And just remind me sir, when did your symptoms all start? , you say a few days ago?\n[Patient] Yeah.\n[Patient] Yeah I would say what day is it today? It's uh, , Wednesday, so it would have been, what is it Saturday, 'cause I was out.\n[Doctor] It's Wednesday.\n[Doctor] OK.\n[Patient] Yeah I was out having dinner, and then, yeah I, I came, yeah, yeah, yeah it would have been that. 'Cause I was out, for my wife's, uh she's, she was, doing this wee thing, we had a wee bit of a celebration, so we were out for that.\n[Doctor] .\n[Patient] And I remember saying to her, it was like you know what? I'm, I'm, I'm not feeling, great. You know I , I stuck it out with her but, aye, it would have been that, Saturday. So, what's that about five, five days ago? Yeah, yeah, yeah, yeah.\n[Doctor] Four, five days ago, yeah. OK. Are you aware of anything that might have set your symptoms off/\n[Patient] No I haven't been, haven't been , I mean, as I said, I was out with my wife. I don't know whether it's like, you know, the restaurant we went to was like, it was like, pretty good, so I wouldn't have expected them to be serving me anything. Dodgy or anything like that but, I , I, I, I don't know, you know. So, , nothing that I can see.\n[Doctor] , OK.\n[Doctor] And , without prying too much, what were you celebrating?\n[Patient] Well, my wife, has just been, uh, promoted. So, she's now going to be, uh, a head teacher, of, of primary school. So, just took her out.\n[Doctor] .\n[Doctor] .\n[Patient] . Yeah, wee, a wee night on the tiles, for that, so uh, it was good, . Yeah, yeah.\n[Doctor] , very nice.\n[Doctor] , good, excellent. So just moving on sir. Uh, regarding your, um, what we say, past medical history. Are you, do you have any other medical problems I should be aware of? So anything to do with your heart, lungs?\n[Patient] Uh, I mean, I'm a , I'm a wee bit, on the chunky side. You know, uh, you know I've, I've got a wee bit, a wee bit round the midriff, the spare tyre's, definitely there. Uh, and I've, I've got the uh, I've got the diabetes.\n[Doctor] Diabetes, right. What type of , is it type one or type two?\n[Patient] Uh, it's, it's uh, type, two, two. Aye, type one, , aye, aye. 'Cause he said, the doctor I spoke to, he was sort of saying like, you know, as a bigger guy, it's, it's kinda, it's kinda like, yeah, and.\n[Doctor] OK, OK.\n[Doctor] And what.\n[Doctor] . Yeah, OK. .\n[Patient] And uh, aye, when I was speaking to uh, it was this, it was other, another doctor I spoke to a while ago but. Aye when he, took the, when he was telling me this as well he, took my blood pressure and that said that was, that was high, uh, high, higher than it should be.\n[Doctor] .\n[Doctor] .\n[Doctor] You've been diagnosed with high blood pressure, uh, or . OK, all right. So um, moving on. Come to your medications, , which medications do you take on a regular basis?\n[Patient] . Yeah, yeah.\n[Patient] Uh, give me, I'm just gonna check. It's, it's, let me know if I'm pronouncing this correctly 'cause I haven't got, I haven't got my glasses with me. So, it's , Metformin?\n[Doctor] , that's correct, OK.\n[Patient] and, and there's another one, , Lisinopril? Is that? Yeah, . I mean that's those two, I had, I've got them written down a wee bit of paper so.\n[Doctor] OK. Lisinopril, yeah. That sounds like.\n[Doctor] No problems, no problem, that's fine. Anything else sir?\n[Patient] Uh, no, no, just, just, just those two. Yeah, I mean a wee bit of like , a wee bit of Aspirin or whatever every now and again, but you know nothing long-term.\n[Doctor] Right.\n[Doctor] OK, all right. And just moving on swiftly sir. Do you have any allergies at all?\n[Patient] Uh, not that I'm, not that I'm aware of. You know, I mean, what, what are the, what are the allergies you get? Just, you know, nah, not.\n[Doctor] Just allergies to , medications really, I'm, I'm asking not, as opposed to um, other things.\n[Patient] Right ah, yeah. No, nothing, nothing that, nothing that I'm aware of, doctor's never said nothing to me, so.\n[Doctor] .\n[Doctor] OK. And just very briefly, socially sir, just it's very important to ask. Uh, you said you live, with your wife. Anyone else at home with you?\n[Patient] Uh, no, no, kids, the kids have uh, they've flown the nest. So uh, now it's just me and the missus, you know, good life.\n[Doctor] OK.\n[Doctor] OK, OK. And are you, yep, and are you working at the moment? Uh, yourself?\n[Patient] Uh, I am. Yep, yeah, yeah um, .\n[Doctor] What, what do you do at work?\n[Patient] Uh, well I'm, it's one of the, there's a wee factory, just uh, down the road, um, so we just you know, we just manufacture like uh. Uh, it's like, kind of steel, steel parts, uh, things like that. You know, so it's a, good wee job, you know, keeps us, a roof over the, over us.\n[Doctor] \n[Doctor] \n[Doctor] . Pays the bills, really. Um.\n[Patient] Yeah, yeah, aye, exact, exactly.\n[Doctor] What, what about smoking and alcohol, sir? Do you, you do either?\n[Patient] Uh.\n[Patient] I, I do, I do like a wee drink. Uh, aye the doc, the old, doctor I had, he, he, he did say I was drinking just a wee, a wee bit too much. I mean I'm not like, you know I'm not, not an alky or anything, but just, just uh, yeah, do like a few, a few pints every now and again.\n[Doctor] roughly on average, how many you would drink a week?\n[Patient] Uh, pints?\n[Doctor] Well, whatever you drink. Is it , beer, lager, wine, spirits?\n[Patient] . You know, maybe, maybe what like four, four pints on like Saturday and then, you know on, Sunday as well, , maybe like. Nine, nine pints in a week, I would say.\n[Doctor] OK, OK. And what about smoking, sir?\n[Patient] Uh, ugh, , a wee, every now and again, but I'm, I, I am trying to cut that down. I've got a wee uh, what are those wee things called? The wee vaporisers.\n[Doctor] Ohh OK, OK.\n[Patient] Yeah I've got, I got, I got myself one of those, so I've been, I've been cutting down on the cigarettes. Uh, and I just got this wee, this wee thing, it's great, it is, it's actually like amazing, by the way.\n[Doctor] Well, I wish you , all the best on your journey to quit, I , I highly recommend it. Um, if you can, it'll certainly help your health as well. Um, so just to , just to summarise, I think you know, uh, based on your story.\n[Patient] Thank you.\n[Doctor] Um, yeah I'm not, worry. I think you know what you essentially have is a bit of a, a bit of a viral illness perhaps, a bit of a, maybe early signs of a flu, um.\n[Patient] Mm-hmm.\n[Doctor] Which I think should, settle down, um, really on it's own, uh, over time. Um, things to you know, you, you can do, help yourself you know, , stay rested, drink plenty of fluids.\n[Patient] Right.\n[Patient] Yes, aye.\n[Doctor] Um, if you are, if you are feeling hot and cold and sweaty, taking regular Paracetamol would be beneficial. Um, you mentioned feeling a bit short of breath. Um, I'm a little bit on the edge about giving you antibiotics. I don't think you've got a chest infection, but what we could think about is giving you a.\n[Patient] Aye.\n[Doctor] A script for antibiotics, which maybe use in next, twenty four to forty eight hours, if your symptoms don't get better.\n[Patient] Right, so , so if, so if I'm, I just , just lie down and take it easy. If I'm still, feeling a bit rubbish then, I go in, I .\n[Doctor] Yeah.\n[Doctor] Yeah, , I will, yeah, I'll, I'll give you a script today, give it about twenty four to forty eight hours. If you feel like you're still feeling breathless and, run-down, I think there's no harm in starting a course of antibiotics, something like Amoxicillin. One tablet, three times a day. Um, uh, and , if you're still not better by next week, come back and see me, we can have another look.\n[Patient] \n[Patient] All right, OK. OK, so I just, plenty of rest, lots of water, hopefully this thing pass.\n[Doctor] Exactly.\n[Doctor] Yes, absolutely.\n[Patient] Right, that is, that's perfect, that's just what, , what I wanted to hear.\n[Doctor] Great, well, I'm, glad I could help. And um, I wish you and your football team all the best.\n[Patient] Cheers.\n[Patient] Aye, I hope so, I hope so. It's not, not looking too good, but uh, aye. Right, cheers, cheers, .\n[Doctor] OK. , all the best. Bye bye.",
"turns": [
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"text": ". Great. Right, how can I help you this afternoon sir?",
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"text": "Uh, I am not feeling, very well.",
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"speaker": "Patient"
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"text": "Well I will certainly try my best, for you. Um, can you tell me a bit more about what's been going on?",
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"text": "Uh, I just feel a bit, run-down, you know I've got, a cough, a cold.",
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"text": ". Mm-hmm.",
"speaker": "Doctor"
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"speaker": "Patient"
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"text": "Mmm. OK, well let's start with your cough first. Tell me a bit more about your cough. Is it, for example are you, coughing up anything at all, or is it mainly dry?",
"speaker": "Doctor"
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"text": "Uh, yeah, yeah, mean, mostly, dry it's a , you know it's a wee bit in the morning it's a bit worse uh, but , and you know it's, it's fairly, fairly dry, aye.",
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"text": "Yeah, yeah, yeah, yeah, yeah, yeah. I don't like to admit that it's, you know it's talk about but, yeah it's , aye, aye. It's a wee bit, wee bit uh, yeah.",
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"text": "Yeah, yeah, yeah, aye, aye you're right. Is that, is that coming through loud and clear on the phone yeah the, the sniffling, yeah, .",
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"text": ". Yeah, sorry to hear that, yeah no . Um, and uh, any other symptoms, so for example have you any, uh, any sore throats, any ear pain?",
"speaker": "Doctor"
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"text": "Yeah, ugh, yeah, yeah. I've, I've had a bit of a sore throat. I mean, I, you know, , I'm doing a lot of uh, you know I'm, , watching the, watching the football as well. So I do a lot of shouting at that, but uh, uh, uh, I'm not sure if that's related or not.",
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"text": "Ah OK. Who do you support?",
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"text": "Uh, well it's a team, called, Partick Thistle. And they're in the, they're not even in the top division, uh, of the Scottish, league. They're actually in the, the, the championship, which is the league below that, and they're, bottom of the table.",
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"text": "Right.",
"speaker": "Doctor"
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"text": "So I've been, shouting myself a wee bit hoarse, 'cause their performance has been, uh, pretty shite, if I'm being honest with you. .",
"speaker": "Patient"
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"text": "Well, all sounds fascinating, well I wish them all the best. nothing table. Um, so, so you mentioned sore throat. Um, and have you had a chance to look in the, in the mirror? Have you had a look at the back of your throat?",
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"text": ", yeah, yeah, yeah.",
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"text": ", aye, I mean aye, I, I shave, every day so I'm, I'm looking at myself, it's not, not, not a pretty sight to be honest at the best of times but it's been a, wee bit, a wee bit rough, uh, the last few days for sure.",
"speaker": "Patient"
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{
"start": 169.04598,
"end": 175.24478,
"text": "Yeah, now, I mean have you any, have you noticed any kind of, white spots on the back of your, back of your throat, or redness?",
"speaker": "Doctor"
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{
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"text": "Ohh right, right aye. , sorry you mean I'm looking ah right yeah uh. , no I, I don't, I don't really like to look, you know to look at it so I, I, I haven't, haven't tried to do any of that.",
"speaker": "Patient"
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{
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"text": ". I understand it's not pretty but as I say it's not, it's not something we, we always um, uh, recommend but um, moving on. In terms of your ears , any dullness or blocked ears, pain in your ears.",
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"text": "Uh, yeah, , a, a wee bit I mean . You know, I'm fit, I'm , I'm fifty years old now and my, my hearing's, you know it's not as good as it used to be but, you know I , I, I think, I think it's all right, it's all right.",
"speaker": "Patient"
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{
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"text": "OK, OK. Fine. Um, moving down to your chest. Um, how's your breathing been? So do, you feel more breathless or tight in your chest?",
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"text": "Uh.",
"speaker": "Patient"
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"start": 227.5305,
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"text": "Uh, no. No, no it's, it's not. No, no, no, .",
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"text": ". So your breathing is ?",
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"text": "No it's, it's, it's, it's not, it's not good. It's not good.",
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"text": "OK. It's not good?",
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"text": "No. No, no.",
"speaker": "Patient"
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{
"start": 248.79715,
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"text": "No, OK, OK. So you're , you're, you're feeling more short of breath?",
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{
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"text": "Yeah, yeah.",
"speaker": "Patient"
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"text": "OK, OK, , OK. Um, any pain in your chest at all?",
"speaker": "Doctor"
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{
"start": 260.23653,
"end": 269.61893,
"text": "No, no it's, it's, it's weird, it's, it's just, you know it's just a wee bit, it's just a wee bit shortness of breath, but it's not, , it's, it's not, it's not pain, you know, as such.",
"speaker": "Patient"
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{
"start": 267.91449,
"end": 275.95901,
"text": "No pain, OK, OK. Have you noticed yourself, any, any, any temperatures or fevers? Um, feeling hot and cold? Sweaty?",
"speaker": "Doctor"
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{
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"text": "Yeah, yeah that's, that's, that's, that's definitely something I've noticed. Like, you know in, in bed with the wife and having to, you know get out and, get the blanket off, and put it back on again it's, it's not, it's not pleasant. I mean, I'm keeping her up at night as well, which is a, bloody nightmare but, I mean, you know how these things are.",
"speaker": "Patient"
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"text": "Yeah, .",
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"start": 293.91647,
"end": 301.73705,
"text": "Seems, seems very difficult at the moment. Um, , have you measured your temperature at all? Have you, got a ?",
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"speaker": "Patient"
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{
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"text": "But uh, no I mean, no you know, you know, I can, I just feel it in my forehead but, I mean, I haven't, haven't, you know, used a thermometer or anything.",
"speaker": "Patient"
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"text": "Mmm, OK.",
"speaker": "Doctor"
},
{
"start": 308.9475,
"end": 318.01686,
"text": "Sure, OK. Um, and just moving on, just very quickly. Um, any other symptoms? Any nausea? Any vomiting? Any tummy pain?",
"speaker": "Doctor"
},
{
"start": 318.94269,
"end": 329.27002,
"text": "Uh, the, the first, the first day I had, you know a wee bit, of uh, , you know uh, you know the rot like, a wee bit of diarrhoea.",
"speaker": "Patient"
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"start": 329.22111,
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"text": ".",
"speaker": "Doctor"
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{
"start": 329.27002,
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"text": "You know but, but that, that's, that's fine, now. Um, and, , yeah but, but apart from that, , no.",
"speaker": "Patient"
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{
"start": 332.9233,
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"text": ".",
"speaker": "Doctor"
},
{
"start": 337.11746,
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"text": "OK. And how's your appetite? Are you eating and drinking OK?",
"speaker": "Doctor"
},
{
"start": 341.70751,
"end": 358.82524,
"text": "Uh, yeah I mean I'm, I'm, I'm trying to and I think what, what is you , you starve, a cold and you, feed the. I, can't remember what it is, but I think I've, uh, my appetite's been, been all right yeah, yeah. I'm trying to, trying to keep, keep the fluids up as well you know, I hear that's what you should do.",
"speaker": "Patient"
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{
"start": 353.29105,
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"text": ".",
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{
"start": 358.73628,
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"text": "Yeah, absolutely, , completely uh, recommend that, so keep, keep doing what you're doing. Um, and just lastly, you know any, any, any kind of muscle pain, joint pains?",
"speaker": "Doctor"
},
{
"start": 361.45761,
"end": 362.4064,
"text": "",
"speaker": "Patient"
},
{
"start": 364.10739,
"end": 364.69291,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 369.51646,
"end": 389.84184,
"text": "Yeah it's, it's, it's just been a wee. I mean again, you know I'm , I'm getting a just a wee bit older now so it, it's, it's not something that I, I was thinking about but, I have, I have noticed like when I, you know, when I'm bending down and. Know moving about, it's just, a wee, a wee bit stiffer than, than normal. , you know and I'm, I think that might be to do with whatever this.",
"speaker": "Patient"
},
{
"start": 385.85265,
"end": 386.59643,
"text": "Mmm.",
"speaker": "Doctor"
},
{
"start": 389.84184,
"end": 393.34774,
"text": "Thing is, but, again it's, you know, I'm just getting on.",
"speaker": "Patient"
},
{
"start": 392.1753,
"end": 394.72948,
"text": "And where do you, where do you feel the stiffness?",
"speaker": "Doctor"
},
{
"start": 395.76835,
"end": 402.86957,
"text": "It it's, just kinda, like you know when you're, when you're bending like, elbows and knees and just, just a wee bit, kinda stiff, you know?",
"speaker": "Patient"
},
{
"start": 402.26161,
"end": 407.84454,
"text": ", all over, OK. And just remind me sir, when did your symptoms all start? , you say a few days ago?",
"speaker": "Doctor"
},
{
"start": 404.24486,
"end": 405.138,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 408.76665,
"end": 417.37142,
"text": "Yeah I would say what day is it today? It's uh, , Wednesday, so it would have been, what is it Saturday, 'cause I was out.",
"speaker": "Patient"
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{
"start": 411.05631,
"end": 412.18155,
"text": "It's Wednesday.",
"speaker": "Doctor"
},
{
"start": 417.27959,
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"text": "OK.",
"speaker": "Doctor"
},
{
"start": 417.37142,
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"text": "Yeah I was out having dinner, and then, yeah I, I came, yeah, yeah, yeah it would have been that. 'Cause I was out, for my wife's, uh she's, she was, doing this wee thing, we had a wee bit of a celebration, so we were out for that.",
"speaker": "Patient"
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{
"start": 430.00367,
"end": 430.52579,
"text": ".",
"speaker": "Doctor"
},
{
"start": 430.0234,
"end": 443.61978,
"text": "And I remember saying to her, it was like you know what? I'm, I'm, I'm not feeling, great. You know I , I stuck it out with her but, aye, it would have been that, Saturday. So, what's that about five, five days ago? Yeah, yeah, yeah, yeah.",
"speaker": "Patient"
},
{
"start": 439.66009,
"end": 450.41137,
"text": "Four, five days ago, yeah. OK. Are you aware of anything that might have set your symptoms off/",
"speaker": "Doctor"
},
{
"start": 450.79985,
"end": 468.53703,
"text": "No I haven't been, haven't been , I mean, as I said, I was out with my wife. I don't know whether it's like, you know, the restaurant we went to was like, it was like, pretty good, so I wouldn't have expected them to be serving me anything. Dodgy or anything like that but, I , I, I, I don't know, you know. So, , nothing that I can see.",
"speaker": "Patient"
},
{
"start": 465.24292,
"end": 466.67091,
"text": ", OK.",
"speaker": "Doctor"
},
{
"start": 469.10006,
"end": 471.70916,
"text": "And , without prying too much, what were you celebrating?",
"speaker": "Doctor"
},
{
"start": 474.1578,
"end": 484.29852,
"text": "Well, my wife, has just been, uh, promoted. So, she's now going to be, uh, a head teacher, of, of primary school. So, just took her out.",
"speaker": "Patient"
},
{
"start": 480.4541,
"end": 480.97593,
"text": ".",
"speaker": "Doctor"
},
{
"start": 483.04676,
"end": 484.41887,
"text": ".",
"speaker": "Doctor"
},
{
"start": 484.29852,
"end": 490.98188,
"text": ". Yeah, wee, a wee night on the tiles, for that, so uh, it was good, . Yeah, yeah.",
"speaker": "Patient"
},
{
"start": 487.27594,
"end": 489.41887,
"text": ", very nice.",
"speaker": "Doctor"
},
{
"start": 491.01049,
"end": 501.99029,
"text": ", good, excellent. So just moving on sir. Uh, regarding your, um, what we say, past medical history. Are you, do you have any other medical problems I should be aware of? So anything to do with your heart, lungs?",
"speaker": "Doctor"
},
{
"start": 500.3968,
"end": 516.88486,
"text": "Uh, I mean, I'm a , I'm a wee bit, on the chunky side. You know, uh, you know I've, I've got a wee bit, a wee bit round the midriff, the spare tyre's, definitely there. Uh, and I've, I've got the uh, I've got the diabetes.",
"speaker": "Patient"
},
{
"start": 516.61817,
"end": 519.82944,
"text": "Diabetes, right. What type of , is it type one or type two?",
"speaker": "Doctor"
},
{
"start": 520.77257,
"end": 538.59085,
"text": "Uh, it's, it's uh, type, two, two. Aye, type one, , aye, aye. 'Cause he said, the doctor I spoke to, he was sort of saying like, you know, as a bigger guy, it's, it's kinda, it's kinda like, yeah, and.",
"speaker": "Patient"
},
{
"start": 523.89769,
"end": 525.24068,
"text": "OK, OK.",
"speaker": "Doctor"
},
{
"start": 527.01961,
"end": 527.63394,
"text": "And what.",
"speaker": "Doctor"
},
{
"start": 534.08728,
"end": 538.34328,
"text": ". Yeah, OK. .",
"speaker": "Doctor"
},
{
"start": 538.59085,
"end": 555.07623,
"text": "And uh, aye, when I was speaking to uh, it was this, it was other, another doctor I spoke to a while ago but. Aye when he, took the, when he was telling me this as well he, took my blood pressure and that said that was, that was high, uh, high, higher than it should be.",
"speaker": "Patient"
},
{
"start": 544.71428,
"end": 545.32272,
"text": ".",
"speaker": "Doctor"
},
{
"start": 553.051,
"end": 553.69828,
"text": ".",
"speaker": "Doctor"
},
{
"start": 555.20528,
"end": 565.59463,
"text": "You've been diagnosed with high blood pressure, uh, or . OK, all right. So um, moving on. Come to your medications, , which medications do you take on a regular basis?",
"speaker": "Doctor"
},
{
"start": 558.15065,
"end": 559.65423,
"text": ". Yeah, yeah.",
"speaker": "Patient"
},
{
"start": 566.41495,
"end": 577.31162,
"text": "Uh, give me, I'm just gonna check. It's, it's, let me know if I'm pronouncing this correctly 'cause I haven't got, I haven't got my glasses with me. So, it's , Metformin?",
"speaker": "Patient"
},
{
"start": 575.73653,
"end": 577.89346,
"text": ", that's correct, OK.",
"speaker": "Doctor"
},
{
"start": 577.31162,
"end": 589.70874,
"text": " and, and there's another one, , Lisinopril? Is that? Yeah, . I mean that's those two, I had, I've got them written down a wee bit of paper so.",
"speaker": "Patient"
},
{
"start": 581.35697,
"end": 585.15758,
"text": "OK. Lisinopril, yeah. That sounds like.",
"speaker": "Doctor"
},
{
"start": 589.27131,
"end": 591.87938,
"text": "No problems, no problem, that's fine. Anything else sir?",
"speaker": "Doctor"
},
{
"start": 593.0764,
"end": 602.80818,
"text": "Uh, no, no, just, just, just those two. Yeah, I mean a wee bit of like , a wee bit of Aspirin or whatever every now and again, but you know nothing long-term.",
"speaker": "Patient"
},
{
"start": 600.24352,
"end": 600.8016,
"text": "Right.",
"speaker": "Doctor"
},
{
"start": 602.79991,
"end": 606.88917,
"text": "OK, all right. And just moving on swiftly sir. Do you have any allergies at all?",
"speaker": "Doctor"
},
{
"start": 606.31621,
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"text": " Uh, not that I'm, not that I'm aware of. You know, I mean, what, what are the, what are the allergies you get? Just, you know, nah, not.",
"speaker": "Patient"
},
{
"start": 615.4864,
"end": 620.49104,
"text": "Just allergies to , medications really, I'm, I'm asking not, as opposed to um, other things.",
"speaker": "Doctor"
},
{
"start": 621.19417,
"end": 627.2089,
"text": "Right ah, yeah. No, nothing, nothing that, nothing that I'm aware of, doctor's never said nothing to me, so.",
"speaker": "Patient"
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{
"start": 625.06762,
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"text": ".",
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{
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"text": "OK. And just very briefly, socially sir, just it's very important to ask. Uh, you said you live, with your wife. Anyone else at home with you?",
"speaker": "Doctor"
},
{
"start": 635.0913,
"end": 642.44427,
"text": "Uh, no, no, kids, the kids have uh, they've flown the nest. So uh, now it's just me and the missus, you know, good life.",
"speaker": "Patient"
},
{
"start": 638.28109,
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"text": "OK.",
"speaker": "Doctor"
},
{
"start": 640.56518,
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"text": "OK, OK. And are you, yep, and are you working at the moment? Uh, yourself?",
"speaker": "Doctor"
},
{
"start": 645.78252,
"end": 649.28922,
"text": "Uh, I am. Yep, yeah, yeah um, .",
"speaker": "Patient"
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{
"start": 647.55176,
"end": 649.02191,
"text": "What, what do you do at work?",
"speaker": "Doctor"
},
{
"start": 650.3598,
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"text": "Uh, well I'm, it's one of the, there's a wee factory, just uh, down the road, um, so we just you know, we just manufacture like uh. Uh, it's like, kind of steel, steel parts, uh, things like that. You know, so it's a, good wee job, you know, keeps us, a roof over the, over us.",
"speaker": "Patient"
},
{
"start": 661.67368,
"end": 663.95261,
"text": "",
"speaker": "Doctor"
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{
"start": 665.50074,
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"text": "",
"speaker": "Doctor"
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{
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"text": ". Pays the bills, really. Um.",
"speaker": "Doctor"
},
{
"start": 670.27996,
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"text": "Yeah, yeah, aye, exact, exactly.",
"speaker": "Patient"
},
{
"start": 672.92246,
"end": 678.27754,
"text": "What, what about smoking and alcohol, sir? Do you, you do either?",
"speaker": "Doctor"
},
{
"start": 676.66322,
"end": 677.62446,
"text": "Uh.",
"speaker": "Patient"
},
{
"start": 679.39941,
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"text": "I, I do, I do like a wee drink. Uh, aye the doc, the old, doctor I had, he, he, he did say I was drinking just a wee, a wee bit too much. I mean I'm not like, you know I'm not, not an alky or anything, but just, just uh, yeah, do like a few, a few pints every now and again.",
"speaker": "Patient"
},
{
"start": 693.30723,
"end": 697.98459,
"text": " roughly on average, how many you would drink a week?",
"speaker": "Doctor"
},
{
"start": 699.58846,
"end": 701.33268,
"text": "Uh, pints?",
"speaker": "Patient"
},
{
"start": 701.25165,
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"text": "Well, whatever you drink. Is it , beer, lager, wine, spirits?",
"speaker": "Doctor"
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{
"start": 705.95925,
"end": 719.98873,
"text": ". You know, maybe, maybe what like four, four pints on like Saturday and then, you know on, Sunday as well, , maybe like. Nine, nine pints in a week, I would say.",
"speaker": "Patient"
},
{
"start": 719.84886,
"end": 722.68124,
"text": "OK, OK. And what about smoking, sir?",
"speaker": "Doctor"
},
{
"start": 723.4063,
"end": 733.85644,
"text": "Uh, ugh, , a wee, every now and again, but I'm, I, I am trying to cut that down. I've got a wee uh, what are those wee things called? The wee vaporisers.",
"speaker": "Patient"
},
{
"start": 733.19177,
"end": 734.69399,
"text": "Ohh OK, OK.",
"speaker": "Doctor"
},
{
"start": 733.85644,
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"text": "Yeah I've got, I got, I got myself one of those, so I've been, I've been cutting down on the cigarettes. Uh, and I just got this wee, this wee thing, it's great, it is, it's actually like amazing, by the way.",
"speaker": "Patient"
},
{
"start": 744.46377,
"end": 755.49583,
"text": "Well, I wish you , all the best on your journey to quit, I , I highly recommend it. Um, if you can, it'll certainly help your health as well. Um, so just to , just to summarise, I think you know, uh, based on your story.",
"speaker": "Doctor"
},
{
"start": 752.22418,
"end": 753.62124,
"text": "Thank you.",
"speaker": "Patient"
},
{
"start": 755.49583,
"end": 764.99206,
"text": "Um, yeah I'm not, worry. I think you know what you essentially have is a bit of a, a bit of a viral illness perhaps, a bit of a, maybe early signs of a flu, um.",
"speaker": "Doctor"
},
{
"start": 756.13596,
"end": 756.8053,
"text": "Mm-hmm.",
"speaker": "Patient"
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{
"start": 764.99206,
"end": 777.17251,
"text": "Which I think should, settle down, um, really on it's own, uh, over time. Um, things to you know, you, you can do, help yourself you know, , stay rested, drink plenty of fluids.",
"speaker": "Doctor"
},
{
"start": 765.76835,
"end": 766.76835,
"text": "Right.",
"speaker": "Patient"
},
{
"start": 776.62,
"end": 778.6013,
"text": "Yes, aye.",
"speaker": "Patient"
},
{
"start": 777.17251,
"end": 792.6969,
"text": "Um, if you are, if you are feeling hot and cold and sweaty, taking regular Paracetamol would be beneficial. Um, you mentioned feeling a bit short of breath. Um, I'm a little bit on the edge about giving you antibiotics. I don't think you've got a chest infection, but what we could think about is giving you a.",
"speaker": "Doctor"
},
{
"start": 783.81255,
"end": 784.53982,
"text": "Aye.",
"speaker": "Patient"
},
{
"start": 792.6969,
"end": 799.18275,
"text": "A script for antibiotics, which maybe use in next, twenty four to forty eight hours, if your symptoms don't get better.",
"speaker": "Doctor"
},
{
"start": 799.90086,
"end": 810.3862,
"text": "Right, so , so if, so if I'm, I just , just lie down and take it easy. If I'm still, feeling a bit rubbish then, I go in, I .",
"speaker": "Patient"
},
{
"start": 805.24045,
"end": 806.20389,
"text": "Yeah.",
"speaker": "Doctor"
},
{
"start": 808.55919,
"end": 827.65471,
"text": "Yeah, , I will, yeah, I'll, I'll give you a script today, give it about twenty four to forty eight hours. If you feel like you're still feeling breathless and, run-down, I think there's no harm in starting a course of antibiotics, something like Amoxicillin. One tablet, three times a day. Um, uh, and , if you're still not better by next week, come back and see me, we can have another look.",
"speaker": "Doctor"
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"start": 823.85374,
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{
"start": 828.19511,
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"text": "All right, OK. OK, so I just, plenty of rest, lots of water, hopefully this thing pass.",
"speaker": "Patient"
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{
"start": 832.75171,
"end": 833.5978,
"text": "Exactly.",
"speaker": "Doctor"
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"text": "Yes, absolutely.",
"speaker": "Doctor"
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{
"start": 837.07438,
"end": 840.2981,
"text": "Right, that is, that's perfect, that's just what, , what I wanted to hear.",
"speaker": "Patient"
},
{
"start": 840.1404,
"end": 846.16171,
"text": "Great, well, I'm, glad I could help. And um, I wish you and your football team all the best.",
"speaker": "Doctor"
},
{
"start": 843.72458,
"end": 844.60337,
"text": "Cheers.",
"speaker": "Patient"
},
{
"start": 846.65106,
"end": 855.56287,
"text": "Aye, I hope so, I hope so. It's not, not looking too good, but uh, aye. Right, cheers, cheers, .",
"speaker": "Patient"
},
{
"start": 851.54119,
"end": 854.99928,
"text": "OK. , all the best. Bye bye.",
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],
"doctor_utterances": "Hello? Hello? Uh, can you hear me OK? . Great. Right, how can I help you this afternoon sir? I'm sorry to. Well I will certainly try my best, for you. Um, can you tell me a bit more about what's been going on? . Mm-hmm. Mmm. OK, well let's start with your cough first. Tell me a bit more about your cough. Is it, for example are you, coughing up anything at all, or is it mainly dry? So you're not bringing up any mucky, flem? OK, all right. Yeah, I can certainly hear you've got the sniffles. So, bit of a runny, bit of a runny nose, you mentioned. . Yeah, sorry to hear that, yeah no . Um, and uh, any other symptoms, so for example have you any, uh, any sore throats, any ear pain? Ah OK. Who do you support? Right. Well, all sounds fascinating, well I wish them all the best. nothing table. Um, so, so you mentioned sore throat. Um, and have you had a chance to look in the, in the mirror? Have you had a look at the back of your throat? Yeah, now, I mean have you any, have you noticed any kind of, white spots on the back of your, back of your throat, or redness? . . . I understand it's not pretty but as I say it's not, it's not something we, we always um, uh, recommend but um, moving on. In terms of your ears , any dullness or blocked ears, pain in your ears. OK, OK. Fine. Um, moving down to your chest. Um, how's your breathing been? So do, you feel more breathless or tight in your chest? . So your breathing is ? Uh, your, your breathing is fine is it? your, it's not laboured, or? OK. It's not good? No, OK, OK. So you're , you're, you're feeling more short of breath? OK, OK, , OK. Um, any pain in your chest at all? No pain, OK, OK. Have you noticed yourself, any, any, any temperatures or fevers? Um, feeling hot and cold? Sweaty? . . Yeah, . Seems, seems very difficult at the moment. Um, , have you measured your temperature at all? Have you, got a ? Mmm, OK. Sure, OK. Um, and just moving on, just very quickly. Um, any other symptoms? Any nausea? Any vomiting? Any tummy pain? . . OK. And how's your appetite? Are you eating and drinking OK? . Yeah, absolutely, , completely uh, recommend that, so keep, keep doing what you're doing. Um, and just lastly, you know any, any, any kind of muscle pain, joint pains? Mmm. And where do you, where do you feel the stiffness? , all over, OK. And just remind me sir, when did your symptoms all start? , you say a few days ago? It's Wednesday. OK. . Four, five days ago, yeah. OK. Are you aware of anything that might have set your symptoms off/ , OK. And , without prying too much, what were you celebrating? . . , very nice. , good, excellent. So just moving on sir. Uh, regarding your, um, what we say, past medical history. Are you, do you have any other medical problems I should be aware of? So anything to do with your heart, lungs? Diabetes, right. What type of , is it type one or type two? OK, OK. And what. . Yeah, OK. . . . You've been diagnosed with high blood pressure, uh, or . OK, all right. So um, moving on. Come to your medications, , which medications do you take on a regular basis? , that's correct, OK. OK. Lisinopril, yeah. That sounds like. No problems, no problem, that's fine. Anything else sir? Right. OK, all right. And just moving on swiftly sir. Do you have any allergies at all? Just allergies to , medications really, I'm, I'm asking not, as opposed to um, other things. . OK. And just very briefly, socially sir, just it's very important to ask. Uh, you said you live, with your wife. Anyone else at home with you? OK. OK, OK. And are you, yep, and are you working at the moment? Uh, yourself? What, what do you do at work? . Pays the bills, really. Um. What, what about smoking and alcohol, sir? Do you, you do either? roughly on average, how many you would drink a week? Well, whatever you drink. Is it , beer, lager, wine, spirits? OK, OK. And what about smoking, sir? Ohh OK, OK. Well, I wish you , all the best on your journey to quit, I , I highly recommend it. Um, if you can, it'll certainly help your health as well. Um, so just to , just to summarise, I think you know, uh, based on your story. Um, yeah I'm not, worry. I think you know what you essentially have is a bit of a, a bit of a viral illness perhaps, a bit of a, maybe early signs of a flu, um. Which I think should, settle down, um, really on it's own, uh, over time. Um, things to you know, you, you can do, help yourself you know, , stay rested, drink plenty of fluids. Um, if you are, if you are feeling hot and cold and sweaty, taking regular Paracetamol would be beneficial. Um, you mentioned feeling a bit short of breath. Um, I'm a little bit on the edge about giving you antibiotics. I don't think you've got a chest infection, but what we could think about is giving you a. A script for antibiotics, which maybe use in next, twenty four to forty eight hours, if your symptoms don't get better. Yeah. Yeah, , I will, yeah, I'll, I'll give you a script today, give it about twenty four to forty eight hours. If you feel like you're still feeling breathless and, run-down, I think there's no harm in starting a course of antibiotics, something like Amoxicillin. One tablet, three times a day. Um, uh, and , if you're still not better by next week, come back and see me, we can have another look. Exactly. Yes, absolutely. Great, well, I'm, glad I could help. And um, I wish you and your football team all the best. OK. , all the best. Bye bye.",
"patient_utterances": "Hello? Yes, yeah I can, I can, cheers. Uh, I am not feeling, very well. And I haven't been feeling well, for, a good few days, now, and, I'm really hoping you can do something about it, because it's been, bugging me, for a while now. Uh, I just feel a bit, run-down, you know I've got, a cough, a cold. You know, my wife's been nagging me. I just, it's just all, yeah, it's just, that, that, that's it, that's it. Uh, yeah, yeah, mean, mostly, dry it's a , you know it's a wee bit in the morning it's a bit worse uh, but , and you know it's, it's fairly, fairly dry, aye. Yeah, yeah, yeah, yeah, yeah, yeah. I don't like to admit that it's, you know it's talk about but, yeah it's , aye, aye. It's a wee bit, wee bit uh, yeah. Yeah, yeah, yeah, aye, aye you're right. Is that, is that coming through loud and clear on the phone yeah the, the sniffling, yeah, . Yeah, ugh, yeah, yeah. I've, I've had a bit of a sore throat. I mean, I, you know, , I'm doing a lot of uh, you know I'm, , watching the, watching the football as well. So I do a lot of shouting at that, but uh, uh, uh, I'm not sure if that's related or not. Uh, well it's a team, called, Partick Thistle. And they're in the, they're not even in the top division, uh, of the Scottish, league. They're actually in the, the, the championship, which is the league below that, and they're, bottom of the table. So I've been, shouting myself a wee bit hoarse, 'cause their performance has been, uh, pretty shite, if I'm being honest with you. . , yeah, yeah, yeah. , aye, I mean aye, I, I shave, every day so I'm, I'm looking at myself, it's not, not, not a pretty sight to be honest at the best of times but it's been a, wee bit, a wee bit rough, uh, the last few days for sure. Ohh right, right aye. , sorry you mean I'm looking ah right yeah uh. , no I, I don't, I don't really like to look, you know to look at it so I, I, I haven't, haven't tried to do any of that. Uh, yeah, , a, a wee bit I mean . You know, I'm fit, I'm , I'm fifty years old now and my, my hearing's, you know it's not as good as it used to be but, you know I , I, I think, I think it's all right, it's all right. Uh. Uh, no. No, no it's, it's not. No, no, no, . , sorry, what was that? No it's, it's, it's, it's not, it's not good. It's not good. No. No, no. Yeah, yeah. No, no it's, it's, it's weird, it's, it's just, you know it's just a wee bit, it's just a wee bit shortness of breath, but it's not, , it's, it's not, it's not pain, you know, as such. Yeah, yeah that's, that's, that's, that's definitely something I've noticed. Like, you know in, in bed with the wife and having to, you know get out and, get the blanket off, and put it back on again it's, it's not, it's not pleasant. I mean, I'm keeping her up at night as well, which is a, bloody nightmare but, I mean, you know how these things are. But uh, no I mean, no you know, you know, I can, I just feel it in my forehead but, I mean, I haven't, haven't, you know, used a thermometer or anything. Uh, the, the first, the first day I had, you know a wee bit, of uh, , you know uh, you know the rot like, a wee bit of diarrhoea. You know but, but that, that's, that's fine, now. Um, and, , yeah but, but apart from that, , no. Uh, yeah I mean I'm, I'm, I'm trying to and I think what, what is you , you starve, a cold and you, feed the. I, can't remember what it is, but I think I've, uh, my appetite's been, been all right yeah, yeah. I'm trying to, trying to keep, keep the fluids up as well you know, I hear that's what you should do. Yeah. Yeah it's, it's, it's just been a wee. I mean again, you know I'm , I'm getting a just a wee bit older now so it, it's, it's not something that I, I was thinking about but, I have, I have noticed like when I, you know, when I'm bending down and. Know moving about, it's just, a wee, a wee bit stiffer than, than normal. , you know and I'm, I think that might be to do with whatever this. Thing is, but, again it's, you know, I'm just getting on. It it's, just kinda, like you know when you're, when you're bending like, elbows and knees and just, just a wee bit, kinda stiff, you know? Yeah. Yeah I would say what day is it today? It's uh, , Wednesday, so it would have been, what is it Saturday, 'cause I was out. Yeah I was out having dinner, and then, yeah I, I came, yeah, yeah, yeah it would have been that. 'Cause I was out, for my wife's, uh she's, she was, doing this wee thing, we had a wee bit of a celebration, so we were out for that. And I remember saying to her, it was like you know what? I'm, I'm, I'm not feeling, great. You know I , I stuck it out with her but, aye, it would have been that, Saturday. So, what's that about five, five days ago? Yeah, yeah, yeah, yeah. No I haven't been, haven't been , I mean, as I said, I was out with my wife. I don't know whether it's like, you know, the restaurant we went to was like, it was like, pretty good, so I wouldn't have expected them to be serving me anything. Dodgy or anything like that but, I , I, I, I don't know, you know. So, , nothing that I can see. Well, my wife, has just been, uh, promoted. So, she's now going to be, uh, a head teacher, of, of primary school. So, just took her out. . Yeah, wee, a wee night on the tiles, for that, so uh, it was good, . Yeah, yeah. Uh, I mean, I'm a , I'm a wee bit, on the chunky side. You know, uh, you know I've, I've got a wee bit, a wee bit round the midriff, the spare tyre's, definitely there. Uh, and I've, I've got the uh, I've got the diabetes. Uh, it's, it's uh, type, two, two. Aye, type one, , aye, aye. 'Cause he said, the doctor I spoke to, he was sort of saying like, you know, as a bigger guy, it's, it's kinda, it's kinda like, yeah, and. And uh, aye, when I was speaking to uh, it was this, it was other, another doctor I spoke to a while ago but. Aye when he, took the, when he was telling me this as well he, took my blood pressure and that said that was, that was high, uh, high, higher than it should be. . Yeah, yeah. Uh, give me, I'm just gonna check. It's, it's, let me know if I'm pronouncing this correctly 'cause I haven't got, I haven't got my glasses with me. So, it's , Metformin? and, and there's another one, , Lisinopril? Is that? Yeah, . I mean that's those two, I had, I've got them written down a wee bit of paper so. Uh, no, no, just, just, just those two. Yeah, I mean a wee bit of like , a wee bit of Aspirin or whatever every now and again, but you know nothing long-term. Uh, not that I'm, not that I'm aware of. You know, I mean, what, what are the, what are the allergies you get? Just, you know, nah, not. Right ah, yeah. No, nothing, nothing that, nothing that I'm aware of, doctor's never said nothing to me, so. Uh, no, no, kids, the kids have uh, they've flown the nest. So uh, now it's just me and the missus, you know, good life. Uh, I am. Yep, yeah, yeah um, . Uh, well I'm, it's one of the, there's a wee factory, just uh, down the road, um, so we just you know, we just manufacture like uh. Uh, it's like, kind of steel, steel parts, uh, things like that. You know, so it's a, good wee job, you know, keeps us, a roof over the, over us. Yeah, yeah, aye, exact, exactly. Uh. I, I do, I do like a wee drink. Uh, aye the doc, the old, doctor I had, he, he, he did say I was drinking just a wee, a wee bit too much. I mean I'm not like, you know I'm not, not an alky or anything, but just, just uh, yeah, do like a few, a few pints every now and again. Uh, pints? . You know, maybe, maybe what like four, four pints on like Saturday and then, you know on, Sunday as well, , maybe like. Nine, nine pints in a week, I would say. Uh, ugh, , a wee, every now and again, but I'm, I, I am trying to cut that down. I've got a wee uh, what are those wee things called? The wee vaporisers. Yeah I've got, I got, I got myself one of those, so I've been, I've been cutting down on the cigarettes. Uh, and I just got this wee, this wee thing, it's great, it is, it's actually like amazing, by the way. Thank you. Mm-hmm. Right. Yes, aye. Aye. Right, so , so if, so if I'm, I just , just lie down and take it easy. If I'm still, feeling a bit rubbish then, I go in, I . All right, OK. OK, so I just, plenty of rest, lots of water, hopefully this thing pass. Right, that is, that's perfect, that's just what, , what I wanted to hear. Cheers. Aye, I hope so, I hope so. It's not, not looking too good, but uh, aye. Right, cheers, cheers, .",
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"reference_note": "{\"day\": 1, \"consultation\": 7, \"presenting_complaint\": \"I have a cough and cold\", \"note\": \"5/7 hx of generally unwell with cough and cold sx. Mainly dry cough. No chest pain. Feeling more SOB. \\nFeeling hot/cold and sweaty. No fevers. \\nSore throat and blocked ears. Also myalgia and arthralgia - mainly stiffness in joints. \\nNo unwell contacts\\nNo nausea/vomiting\\nNo bowel symptoms\\n\\n\\nPMH: obesity, diabetes - type 2 , hypertension\\nDH: metformin, lisinopril , aspirin, \\nNKDA\\nSH: lives with wife, works in factory/manufacturing, smoking socially, etOH - >14 units/week \\n\\nImp: viral URTI/? LRTI\\n\\nPlan:\\n1.\\tConservative mx - rest, fluids, regular paracetamol \\n2.\\tDelayed script for amoxicillin abx - to start in 24-48 hours if sx not improving\\n3.\\tReview in 1/52 INB, or earlier if worsening sx (chest pain, SOB, fevers)\\n\", \"highlights\": [\"cough\", \"SOB\", \"Sore throat and blocked ears\", \"myalgia\", \"viral URTI/? LRTI\"]}",
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"dialogue": "[Patient] OK. Ohh, OK.\n[Doctor] Hello?\n[Patient] Hello, can you hear me?\n[Doctor] Hello. Uh, just before we go any further, can I confirm your name and, age please?\n[Patient] Uh, my name's Itha, and I'm twenty six.\n[Doctor] Twenty six, OK. And how can I help you this afternoon?\n[Patient] Um, so basically, I've been really stressed at work for the past few days. And, I've realised that I've got, really dry itchy skin.\n[Doctor] OK. Um, sorry to hear work's been so stressful. Um. Tell me more about your skin first, Lou. Tell me uh, you mentioned it's been dry and itchy. Um, whereabouts on your skin?\n[Patient] All over my arms, um, and my hands mainly.\n[Doctor] OK. Um, and is this something you've had before?\n[Patient] Uh, no. Never had .\n[Doctor] So, uh, did it, did it come about quite suddenly, or was it more, kind of a gradual thing?\n[Patient] I think it started a few days ago.\n[Doctor] OK. And, has this spread anywhere else? Has it spread to your, to your chest, your legs, your face?\n[Patient] \n[Doctor] No, OK. So apart from being dry and itchy, um, any other symptoms? Has it been sore? Has it been, uh, have you noticed any cracked skin?\n[Patient] Um, so my skin's quite red, um, and I'm using coconut butter for the past few days.\n[Doctor] OK. Has that.\n[Patient] I don't have any spots, and no fever , and I'm not sweating either.\n[Doctor] OK.\n[Doctor] Thank you, for mentioning all those. Um, OK. Uh, so the coconut butter hasn't helped, with the itch?\n[Patient] No, .\n[Doctor] OK. And, uh, you mentioned work's been quite stressful. What do you do for work?\n[Patient] Um, I work as a teacher.\n[Doctor] OK. And, uh, in what way has work been stressful?\n[Patient] I think the kids have been really annoying these days.\n[Doctor] OK. .\n[Patient] And, I've been working really long hours.\n[Doctor] OK, all right. Well I'm sorry to hear that, and I hope it gets better. Um, going back to your skin. I mean is it anything you've done perhaps, uh, which may have triggered your symptoms? Anything you've touched or, you know, for example shower gels, soaps, fabric , fabric cleaners?\n[Patient] , I went swimming a few days ago.\n[Doctor] OK. Is that the first time in your life or have you been before?\n[Patient] Uh, no, I've been before.\n[Doctor] OK. And did your symptoms start after you went swimming?\n[Patient] Uh, yes, .\n[Doctor] OK, all right. Um, you mentioned you've had no other fevers, is that right? No fevers? No vomiting?\n[Patient] No.\n[Doctor] No. How's your health otherwise?\n[Patient] It's pretty good, yeah. I'm not on any medication.\n[Doctor] And all , we'll get to medication in just a second. Um, , do you, do you feel generally run-down? Do you feel tired?\n[Patient] Uh, yeah, I think I have been, quite tired.\n[Doctor] OK, OK. Are you eating and drinking OK?\n[Patient] Yeah, I've been drinking, and eating as normal.\n[Doctor] Your appetite's fine is it? OK. And your bowels, are your bowels working OK?\n[Patient] Yeah.\n[Doctor] Uh, no, no problems with vomiting, or loose stools?\n[Patient] No.\n[Doctor] OK. And your waterworks are uh, all OK? You're passing urine OK?\n[Patient] Yep.\n[Doctor] OK, all right. Um, so just moving on. In terms of your other medical history, is there anything else I should be aware of?\n[Patient] I'm currently taking .\n[Doctor] Microgynon.\n[Patient] Yeah.\n[Doctor] OK. Do you know what that is?\n[Patient] Uh, no.\n[Doctor] OK. , it's a contraceptive pill\n[Patient] \n[Doctor] Does that make sense? Is that something you're, is that, does that ring a bell now?\n[Patient] Ohh yeah.\n[Doctor] OK. Is there, any other medications that you take?\n[Patient] Uh, no.\n[Doctor] No. So, in terms of your medical history, there's no, problems of skin problems in the past, things like eczema or, um, dermatitis?\n[Patient] Uh, no, I think it might just be the weather.\n[Doctor] Sorry what was that? You think it's. The .\n[Patient] I think it might just be the weather.\n[Doctor] The weather?\n[Patient] Yeah, .\n[Doctor] Ohh, you think the , OK. You think the weather, OK. OK. No that's OK, no, no problems. Well um, uh, move . Do you, do you suffer from allergies? Are you someone who suffers from allergies?\n[Patient] Um.\n[Doctor] Food allergies? Medication allergies?\n[Patient] I think, um, I might be lactose intolerant.\n[Doctor] Lactose intolerant, OK, that could be helpful to know. Um, fine. And tell me of family history, is there anything in the family that you're aware of?\n[Patient] Um, yeah, so um, my dad has asthma, and, my mum has hayfever.\n[Doctor] Hayfever, OK. Um, fine, but any, again, any skin problems that you're aware of?\n[Patient] Yep.\n[Patient] Uh, no.\n[Doctor] No, OK, all right. Socially, who do you live with at home?\n[Patient] Ohh, it's just me.\n[Doctor] Live alone?\n[Patient] Yep.\n[Doctor] And, uh, do you smoke at all? Do you, can I ask? Do you smoke? Are you a smoker?\n[Patient] Uh, no, I don't smoke.\n[Doctor] Do you drink much in the way of alcohol?\n[Patient] Uh, no.\n[Doctor] Recreational drugs?\n[Patient] No.\n[Doctor] OK. And you said you , you work as a primary school teacher?\n[Patient] Yes, that's right.\n[Doctor] Uh , the reason I ask is sometimes stress can be a , contributing factor. Um, you felt, you noticed yourself, find, uh, , life's been more stressful recently. Is that right? Do you think that might have any correlation to your symptoms?\n[Patient] I don't. I certainly think so.\n[Doctor] OK, all right. Um, fine. Um. OK, well, normally at this stage I like to proceed to examination, but um, based on your uh, story. Um, it's difficult. I think that, you know, , you've, essentially the story is you've got a dry itchy rash on your, mainly your hands. you mentioned. Um and your arms which started, perhaps after swimming a few days ago. Um, but no other symptoms, you're feeling otherwise, well, no fevers, no bleeding or discharge from skin.\n[Patient] Yep.\n[Doctor] I wonder whether you may have something called dermatitis. Um, have you heard of that condition before?\n[Patient] I have, yeah.\n[Doctor] OK. Um, great. Well I can give you a patient information leaflet about that, which gives a bit more information about the disease, but, um, it, it's something that we can readily treated. Um. With couple options, we have steroid creams I can give you, um, which will help with the inflammation. And, uh, something called emollients, which can help with the dry, dry skin. And that's something you just need to kind of paste on, uh, on to your skin, uh, , throughout the day for the next few days. Um, and hopefully that helps your symptoms.\n[Patient] OK, it's cool. Thank you very much.\n[Doctor] Um, , you can also try antihistamines, so you can get things over the counter, Piriton, Loratadine, they can sometimes help with the itchiness.\n[Patient] Yeah, that sounds good.\n[Doctor] OK. And um, that's probably what I recommend. Paracetamol on this occasion, wouldn't be helpful. Um, uh, uh, painkillers wouldn't be helpful , on this occasion, but let's, let's, let's see how the next few days go. And if it's still not getting better, come back and see me next week, and we can have another look again, at your symptoms.\n[Patient] OK, perfect. Thank you very much.\n[Doctor] Right. Do you have any questions for me?\n[Patient] Uh, no.\n[Doctor] OK. Well, I wish you all the best. Have a good day.\n[Patient] Well, thank you very much. Bye.\n[Doctor] Thank you. Bye bye.",
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"text": "OK. And you said you , you work as a primary school teacher?",
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"text": "Yes, that's right.",
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"text": "Uh , the reason I ask is sometimes stress can be a , contributing factor. Um, you felt, you noticed yourself, find, uh, , life's been more stressful recently. Is that right? Do you think that might have any correlation to your symptoms?",
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"text": " I don't. I certainly think so.",
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"text": "OK, all right. Um, fine. Um. OK, well, normally at this stage I like to proceed to examination, but um, based on your uh, story. Um, it's difficult. I think that, you know, , you've, essentially the story is you've got a dry itchy rash on your, mainly your hands. you mentioned. Um and your arms which started, perhaps after swimming a few days ago. Um, but no other symptoms, you're feeling otherwise, well, no fevers, no bleeding or discharge from skin.",
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"text": "Yep.",
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"text": "I wonder whether you may have something called dermatitis. Um, have you heard of that condition before?",
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"text": "OK. Um, great. Well I can give you a patient information leaflet about that, which gives a bit more information about the disease, but, um, it, it's something that we can readily treated. Um. With couple options, we have steroid creams I can give you, um, which will help with the inflammation. And, uh, something called emollients, which can help with the dry, dry skin. And that's something you just need to kind of paste on, uh, on to your skin, uh, , throughout the day for the next few days. Um, and hopefully that helps your symptoms.",
"speaker": "Doctor"
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"text": "OK, it's cool. Thank you very much.",
"speaker": "Patient"
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"text": "Um, , you can also try antihistamines, so you can get things over the counter, Piriton, Loratadine, they can sometimes help with the itchiness.",
"speaker": "Doctor"
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"text": "Yeah, that sounds good.",
"speaker": "Patient"
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"text": "OK. And um, that's probably what I recommend. Paracetamol on this occasion, wouldn't be helpful. Um, uh, uh, painkillers wouldn't be helpful , on this occasion, but let's, let's, let's see how the next few days go. And if it's still not getting better, come back and see me next week, and we can have another look again, at your symptoms.",
"speaker": "Doctor"
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"text": "OK, perfect. Thank you very much.",
"speaker": "Patient"
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"text": "Right. Do you have any questions for me?",
"speaker": "Doctor"
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"text": "Uh, no.",
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"text": "OK. Well, I wish you all the best. Have a good day.",
"speaker": "Doctor"
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"text": "Well, thank you very much. Bye.",
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"text": "Thank you. Bye bye.",
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"doctor_utterances": "Hello? Hello. Uh, just before we go any further, can I confirm your name and, age please? Twenty six, OK. And how can I help you this afternoon? OK. Um, sorry to hear work's been so stressful. Um. Tell me more about your skin first, Lou. Tell me uh, you mentioned it's been dry and itchy. Um, whereabouts on your skin? OK. Um, and is this something you've had before? So, uh, did it, did it come about quite suddenly, or was it more, kind of a gradual thing? OK. And, has this spread anywhere else? Has it spread to your, to your chest, your legs, your face? No, OK. So apart from being dry and itchy, um, any other symptoms? Has it been sore? Has it been, uh, have you noticed any cracked skin? OK. Has that. OK. Thank you, for mentioning all those. Um, OK. Uh, so the coconut butter hasn't helped, with the itch? OK. And, uh, you mentioned work's been quite stressful. What do you do for work? OK. And, uh, in what way has work been stressful? OK. . OK, all right. Well I'm sorry to hear that, and I hope it gets better. Um, going back to your skin. I mean is it anything you've done perhaps, uh, which may have triggered your symptoms? Anything you've touched or, you know, for example shower gels, soaps, fabric , fabric cleaners? OK. Is that the first time in your life or have you been before? OK. And did your symptoms start after you went swimming? OK, all right. Um, you mentioned you've had no other fevers, is that right? No fevers? No vomiting? No. How's your health otherwise? And all , we'll get to medication in just a second. Um, , do you, do you feel generally run-down? Do you feel tired? OK, OK. Are you eating and drinking OK? Your appetite's fine is it? OK. And your bowels, are your bowels working OK? Uh, no, no problems with vomiting, or loose stools? OK. And your waterworks are uh, all OK? You're passing urine OK? OK, all right. Um, so just moving on. In terms of your other medical history, is there anything else I should be aware of? Microgynon. OK. Do you know what that is? OK. , it's a contraceptive pill Does that make sense? Is that something you're, is that, does that ring a bell now? OK. Is there, any other medications that you take? No. So, in terms of your medical history, there's no, problems of skin problems in the past, things like eczema or, um, dermatitis? Sorry what was that? You think it's. The . The weather? Ohh, you think the , OK. You think the weather, OK. OK. No that's OK, no, no problems. Well um, uh, move . Do you, do you suffer from allergies? Are you someone who suffers from allergies? Food allergies? Medication allergies? Lactose intolerant, OK, that could be helpful to know. Um, fine. And tell me of family history, is there anything in the family that you're aware of? Hayfever, OK. Um, fine, but any, again, any skin problems that you're aware of? No, OK, all right. Socially, who do you live with at home? Live alone? And, uh, do you smoke at all? Do you, can I ask? Do you smoke? Are you a smoker? Do you drink much in the way of alcohol? Recreational drugs? OK. And you said you , you work as a primary school teacher? Uh , the reason I ask is sometimes stress can be a , contributing factor. Um, you felt, you noticed yourself, find, uh, , life's been more stressful recently. Is that right? Do you think that might have any correlation to your symptoms? OK, all right. Um, fine. Um. OK, well, normally at this stage I like to proceed to examination, but um, based on your uh, story. Um, it's difficult. I think that, you know, , you've, essentially the story is you've got a dry itchy rash on your, mainly your hands. you mentioned. Um and your arms which started, perhaps after swimming a few days ago. Um, but no other symptoms, you're feeling otherwise, well, no fevers, no bleeding or discharge from skin. I wonder whether you may have something called dermatitis. Um, have you heard of that condition before? OK. Um, great. Well I can give you a patient information leaflet about that, which gives a bit more information about the disease, but, um, it, it's something that we can readily treated. Um. With couple options, we have steroid creams I can give you, um, which will help with the inflammation. And, uh, something called emollients, which can help with the dry, dry skin. And that's something you just need to kind of paste on, uh, on to your skin, uh, , throughout the day for the next few days. Um, and hopefully that helps your symptoms. Um, , you can also try antihistamines, so you can get things over the counter, Piriton, Loratadine, they can sometimes help with the itchiness. OK. And um, that's probably what I recommend. Paracetamol on this occasion, wouldn't be helpful. Um, uh, uh, painkillers wouldn't be helpful , on this occasion, but let's, let's, let's see how the next few days go. And if it's still not getting better, come back and see me next week, and we can have another look again, at your symptoms. Right. Do you have any questions for me? OK. Well, I wish you all the best. Have a good day. Thank you. Bye bye.",
"patient_utterances": "OK. Ohh, OK. Hello, can you hear me? Uh, my name's Itha, and I'm twenty six. Um, so basically, I've been really stressed at work for the past few days. And, I've realised that I've got, really dry itchy skin. All over my arms, um, and my hands mainly. Uh, no. Never had . I think it started a few days ago. Um, so my skin's quite red, um, and I'm using coconut butter for the past few days. I don't have any spots, and no fever , and I'm not sweating either. No, . Um, I work as a teacher. I think the kids have been really annoying these days. And, I've been working really long hours. , I went swimming a few days ago. Uh, no, I've been before. Uh, yes, . No. It's pretty good, yeah. I'm not on any medication. Uh, yeah, I think I have been, quite tired. Yeah, I've been drinking, and eating as normal. Yeah. No. Yep. I'm currently taking . Yeah. Uh, no. Ohh yeah. Uh, no. Uh, no, I think it might just be the weather. I think it might just be the weather. Yeah, . Um. I think, um, I might be lactose intolerant. Um, yeah, so um, my dad has asthma, and, my mum has hayfever. Yep. Uh, no. Ohh, it's just me. Yep. Uh, no, I don't smoke. Uh, no. No. Yes, that's right. I don't. I certainly think so. Yep. I have, yeah. OK, it's cool. Thank you very much. Yeah, that sounds good. OK, perfect. Thank you very much. Uh, no. Well, thank you very much. Bye.",
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"reference_note": "{\"day\": 1, \"consultation\": 8, \"presenting_complaint\": \"I have dry, itchy skin\", \"note\": \"3/7 hx of dry itchy skin, mainly on the hands and palms. No spread elsewhere. No bleeding/discharge. No cracked skin. Sx started after going swimming. No prev skin problems. \\nNo fevers. No vomiting. \\nAppetite maintained, nil nausea/vomiting \\nNil bowel/urinary sx \\n\\nPMH: Lactose intolerance\\nDH: microgynon\\nNKDA\\nFH: Father - asthma, Mother - hayfever \\nSH: - lives alone, nil smoker/etOH/recreational drugs , works as primary school teacher. Recent stress ++\\n\\nImp: dermatitis\\n\\nPlan:\\n1.\\tSteroid cream BD\\n2.\\tEmollients - regular use QDS\\n3.\\tAntihistamines \\n4.\\tReview sx in 1/52, or earlier if worsening sx/any concerns\\n\", \"highlights\": [\"3/7 hx of dry itchy skin\", \"Lactose intolerance\", \"Father - asthma\", \"Mother - hayfever\", \"dermatitis\"]}",
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"dialogue": "[Patient] Hello?\n[Doctor] Hello?\n[Doctor] Hello? I can hear you, can you hear me? . Excellent, just before I go any further, can you confirm your name and your age, please?\n[Patient] Hi. Can you hear me? Yeah, I can hear you now.\n[Patient] Uh, yeah. My name is Jessica Smith, and I'm nineteen years old.\n[Doctor] OK. And how can I help you Mrs Smith?\n[Patient] Um, yeah so uh, I mean this is, this is a bit embarrassing, but it's, it's uh, hurting when I, , when I use the bathroom, when I pee. And um, it's been going on for a few days, so I'm a, I'm a little bit worried about it. Uh, not sure what to do.\n[Doctor] Right, well , I, thank you for coming in, so hopefully we can help with your symptoms. Um, so you mentioned it started a few days ago. Um, so, can you tell me a bit more about that, what kind of pain it is, that you're experiencing?\n[Patient] Um, it's, it's not too bad, it's sort of like a stinging kind of pain. Um. It's not like unbearable, but uh, it's , it's definitely uh, it definitely bothers me when I pee. Um. And uh, yeah I also maybe sometimes get some like, pain kind of lower down in my tummy, when I, when I go to the bathroom. Uh, yeah.\n[Doctor] \n[Doctor] , OK. And, and, uh, the pain in your tummy, is it, can you describe the , the pain to me? Is it cramping, burning, sharp?\n[Patient] , yeah, I don't know maybe uh, sort of, sort of cramping. I'm not really sure, but it's not like, it's not like cramping like when I get, when I have a period or something. It's like, I don't know, .\n[Doctor] Right, right, OK, OK. Um, fine. And, have you found yourself going to the toilet more often than normal?\n[Patient] Um, not, I don't think so, I haven't noticed that.\n[Doctor] No, OK, fine. Have you noticed any, any funny colour to your urine? So, has there been, uh, , any blood in your urine? Have you noticed any other darkening of urine?\n[Patient] Um, there was a little bit of blood earlier today, um, but besides that, not at all, no. Um. It does kind of, it, it kind of like, doesn't smell very, it smells a bit weird I guess, um, but, no, not really anything uh, anything drastic.\n[Doctor] Yes.\n[Doctor] \n[Doctor] OK, fine, OK. Um, right, let me just , write a few notes down as well. Um. , and you mentioned a tummy pain, that also started a few days ago. Does the pain move anywhere else? Does it move towards the back, or towards your flank, the sides?\n[Patient] No, not really, no.\n[Doctor] No, OK, fine. With those symptoms, have you noticed any other symptoms like nausea, vomiting?\n[Patient] Uh, no, not , not at all.\n[Doctor] OK. Any fevers, or temperatures?\n[Patient] think so.\n[Doctor] , sorry, was there any, any fevers or temperatures? Sorry, I didn't hear you.\n[Patient] No, no, no fever, no.\n[Doctor] No fever, OK, fine, sorry. Um, OK. Um, in terms of your bowel, are your bowels working OK?\n[Patient] Um, uh, I think so, yeah, it seems .\n[Doctor] So, uh, by that I mean, um, any, any diarrhoea, loose stool?\n[Patient] Uh, no, not that I've, not that I've noticed at all.\n[Doctor] OK, all right. And um, Jessica, sometimes we have to ask very private sensitive questions, uh, just to , get a full history. Um, hope you don't mind me asking, but are you currently sexually active?\n[Patient] \n[Patient] Uh, yeah I am.\n[Doctor] OK, is that with a regular, partner?\n[Patient] Ohh, yeah, so I, I've had a boyfriend for about a, a couple of months now, yeah.\n[Doctor] Fine, OK. Um, have you noticed any other discharge from, from down below?\n[Patient] I haven't noticed anything.\n[Doctor] No, OK. When was your last um, uh, last STD screen? If, if ever?\n[Patient] Don't think I've ever, I don't think I've ever had one.\n[Doctor] No, OK, fine. And, and um. Do you use any form of contraception, at all?\n[Patient] Uh, yeah, we use condoms.\n[Doctor] You use condoms, OK. And when was your last, period?\n[Patient] Uh, couple of weeks ago.\n[Doctor] Three weeks ago, OK. Is there any chance you could be pregnant perhaps?\n[Patient] Say again.\n[Doctor] Is there any chance you could be pregnant?\n[Patient] Uh, I don't think so, I don't.\n[Doctor] No, no. , it's always worth asking uh, young females like yourself, um. Uh, um, so if that obviously you are worried about the pain.\n[Patient] Yeah.\n[Doctor] Um, not getting any better, uh, then I'd always , advise getting a pregnancy test, to rule out pregnancy. OK? Um, fine. So just moving on, moving on. Are you otherwise fit and well?\n[Patient] Uh-huh.\n[Patient] Um, yeah, I think I'm, I'm feeling OK, otherwise, yeah.\n[Doctor] And so by that I mean, do you have any other medical problems, medical , medical history?\n[Patient] Um, so, in the past I've had some uh, some IBS. Um. But, other than that I think no like uh, real serious medical problems that seem, yeah.\n[Doctor] OK. Do you take any regular medications?\n[Patient] Uh, no, I did uh, I did uh, a little bit ago, or a couple of days ago, try some uh, over the counter bicarbonate, to try and help with the pain but it wasn't, it wasn't really helping.\n[Doctor] OK. So you've tried that and it didn't help? OK, all right. Um, do you have any allergies to any medications?\n[Patient] Uh, yeah, I'm allergic to, Clindamycin.\n[Doctor] And what happens when you take Clindamycin?\n[Patient] Um, I, I get some like a, a, a swelling, basically.\n[Doctor] Right then, OK. So it's quite a, seems like a quite severe allergy to it, is , is that right? Um, OK. Fine. In terms of your family history, is there anything I should be aware of, um, related to kidneys, bladder, bowels, guts?\n[Patient] Yeah.\n[Patient] Uh, no I don't think so, not that I, not anything I know about.\n[Doctor] OK, all right. And tell me a bit more about your home situation. Who's lives, who's at home with you?\n[Patient] Um, so I live in a, live in a flat near my college, with a, a couple of like friends of mine. Uh, so I'm, I'm not like living at home or anything. Um.\n[Doctor] OK, and what .\n[Patient] about sorry.\n[Doctor] OK, and are you a, are you working at the moment, or are you a student?\n[Patient] I'm a student.\n[Doctor] OK, and what are you studying?\n[Patient] Uh, I'm studying biology.\n[Doctor] And how's that going?\n[Patient] Um, it's good yeah, it's really, it's really interesting uh, learning about, learning about how uh, how the world works, yeah.\n[Doctor] great. Do you have any aspirations for the future, in terms of careers?\n[Patient] Uh, I don't know, maybe a doctor someday, you never know.\n[Doctor] , recommend it, we need doctors. Um, what about smoking and alcohol? Do you drink much in the way of, , do you, do you smoke, or do you drink much in the way of alcohol?\n[Patient] Uh, I don't, I don't smoke, uh, I do drink, like on the weekends, yeah.\n[Doctor] , so socially, OK. All right. Um, right, excellent. So, um, at this stage I , I would proceed to examination.\n[Patient] Yeah.\n[Doctor] But um, based on your story, um, just to summarise really. So, last three days, you've been having bit of burning pain on passing urine. A bit of, crampy tummy pain lower down. Um, , essentially but, but no other fevers or back pain, uh, if I, if I understand correctly.\n[Patient] \n[Doctor] I think probably do have what we call a simple UTI or urinary tract infection, bladder infection, um, which can be readily treated. So, I'll give you a course of antibiotics today.\n[Patient] Mm-hmm.\n[Patient] OK.\n[Doctor] Something, called either Nitrofurantoin, or Trimethoprim. Uh, and it's normally a three day course. Uh, so, one tablet, twice a day, for three days.\n[Patient] OK.\n[Doctor] And , that should hopefully help your symptoms, but I also advise you to drink plenty of fluids. Let's try and flush that, you know, that infection out of your body, if you can.\n[Patient] OK.\n[Doctor] Um, you can try, cranberry juice, that can sometimes help with your symptoms. Um, and if you're still not better, by the end of this week, I want you to give me a call or come back and see me. And uh, we can have another look at your symptoms.\n[Patient] \n[Patient] OK, so three days of the medication, and then wait a little bit, if it still doesn't go away, call back, that OK?\n[Doctor] OK.\n[Doctor] Yeah, yeah absolutely. And things to look out for would be, you know, if you are having kind of, high temperatures, a back pain, um just , generally feeling more unwell. Uh, you know, I do want you give me a call back, 'cause then we do worry whether your infection may be spreading up towards your kidneys, which is something we wanna avoid. So, do, do give me a call if you're having any concerns, OK.\n[Patient] OK.\n[Patient] OK, is there, is there anything like, like, should I be worried about? Like, like, not having sex or anything within the next week, or anything like this?\n[Doctor] Yeah I mean if you can try and avoid it, I think that'd be sensible. Um, uh, it's great that you're using barrier contraception. I would recommend you to continue using barrier contraception, but if you can avoid it while your symptoms clear up. That'd probably be the best for you and your boyfriend,.\n[Patient] OK, OK. Uh, that, that makes sense. Ohh, OK, thank you so much.\n[Doctor] All right. Great. Thank you very much. Wish you all the best.\n[Patient] Yeah, thank you. Take care.\n[Doctor] ",
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"text": "OK, all right. And um, Jessica, sometimes we have to ask very private sensitive questions, uh, just to , get a full history. Um, hope you don't mind me asking, but are you currently sexually active?",
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"text": "Fine, OK. Um, have you noticed any other discharge from, from down below?",
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"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 264.13551,
"end": 277.18815,
"text": "Um, not getting any better, uh, then I'd always , advise getting a pregnancy test, to rule out pregnancy. OK? Um, fine. So just moving on, moving on. Are you otherwise fit and well?",
"speaker": "Doctor"
},
{
"start": 264.61411,
"end": 265.61411,
"text": "Uh-huh.",
"speaker": "Patient"
},
{
"start": 278.36599,
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"text": "Um, yeah, I think I'm, I'm feeling OK, otherwise, yeah.",
"speaker": "Patient"
},
{
"start": 281.28589,
"end": 285.69943,
"text": "And so by that I mean, do you have any other medical problems, medical , medical history?",
"speaker": "Doctor"
},
{
"start": 286.67259,
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"text": "Um, so, in the past I've had some uh, some IBS. Um. But, other than that I think no like uh, real serious medical problems that seem, yeah.",
"speaker": "Patient"
},
{
"start": 297.03027,
"end": 300.07538,
"text": "OK. Do you take any regular medications?",
"speaker": "Doctor"
},
{
"start": 300.97922,
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"text": "Uh, no, I did uh, I did uh, a little bit ago, or a couple of days ago, try some uh, over the counter bicarbonate, to try and help with the pain but it wasn't, it wasn't really helping.",
"speaker": "Patient"
},
{
"start": 311.47388,
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"text": "OK. So you've tried that and it didn't help? OK, all right. Um, do you have any allergies to any medications?",
"speaker": "Doctor"
},
{
"start": 318.25377,
"end": 321.45375,
"text": "Uh, yeah, I'm allergic to, Clindamycin.",
"speaker": "Patient"
},
{
"start": 321.82727,
"end": 324.18818,
"text": "And what happens when you take Clindamycin?",
"speaker": "Doctor"
},
{
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"text": "Um, I, I get some like a, a, a swelling, basically.",
"speaker": "Patient"
},
{
"start": 329.58668,
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"text": "Right then, OK. So it's quite a, seems like a quite severe allergy to it, is , is that right? Um, OK. Fine. In terms of your family history, is there anything I should be aware of, um, related to kidneys, bladder, bowels, guts?",
"speaker": "Doctor"
},
{
"start": 334.64358,
"end": 335.44201,
"text": "Yeah.",
"speaker": "Patient"
},
{
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"text": "Uh, no I don't think so, not that I, not anything I know about.",
"speaker": "Patient"
},
{
"start": 348.24083,
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"text": "OK, all right. And tell me a bit more about your home situation. Who's lives, who's at home with you?",
"speaker": "Doctor"
},
{
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"text": "Um, so I live in a, live in a flat near my college, with a, a couple of like friends of mine. Uh, so I'm, I'm not like living at home or anything. Um.",
"speaker": "Patient"
},
{
"start": 364.45888,
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"text": "OK, and what .",
"speaker": "Doctor"
},
{
"start": 365.01857,
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"text": " about sorry.",
"speaker": "Patient"
},
{
"start": 367.51903,
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"text": "OK, and are you a, are you working at the moment, or are you a student?",
"speaker": "Doctor"
},
{
"start": 371.31525,
"end": 372.31525,
"text": "I'm a student.",
"speaker": "Patient"
},
{
"start": 372.36866,
"end": 373.85738,
"text": "OK, and what are you studying?",
"speaker": "Doctor"
},
{
"start": 374.46854,
"end": 376.47584,
"text": "Uh, I'm studying biology.",
"speaker": "Patient"
},
{
"start": 376.33859,
"end": 377.73708,
"text": "And how's that going?",
"speaker": "Doctor"
},
{
"start": 378.49775,
"end": 386.09632,
"text": "Um, it's good yeah, it's really, it's really interesting uh, learning about, learning about how uh, how the world works, yeah.",
"speaker": "Patient"
},
{
"start": 385.11303,
"end": 388.9401,
"text": " great. Do you have any aspirations for the future, in terms of careers?",
"speaker": "Doctor"
},
{
"start": 389.3737,
"end": 395.17664,
"text": "Uh, I don't know, maybe a doctor someday, you never know.",
"speaker": "Patient"
},
{
"start": 393.89499,
"end": 402.67695,
"text": ", recommend it, we need doctors. Um, what about smoking and alcohol? Do you drink much in the way of, , do you, do you smoke, or do you drink much in the way of alcohol?",
"speaker": "Doctor"
},
{
"start": 403.15477,
"end": 407.77523,
"text": "Uh, I don't, I don't smoke, uh, I do drink, like on the weekends, yeah.",
"speaker": "Patient"
},
{
"start": 407.14312,
"end": 416.17107,
"text": ", so socially, OK. All right. Um, right, excellent. So, um, at this stage I , I would proceed to examination.",
"speaker": "Doctor"
},
{
"start": 409.53436,
"end": 410.70922,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 416.17107,
"end": 433.78635,
"text": "But um, based on your story, um, just to summarise really. So, last three days, you've been having bit of burning pain on passing urine. A bit of, crampy tummy pain lower down. Um, , essentially but, but no other fevers or back pain, uh, if I, if I understand correctly.",
"speaker": "Doctor"
},
{
"start": 427.05268,
"end": 428.05268,
"text": "",
"speaker": "Patient"
},
{
"start": 433.78635,
"end": 444.67869,
"text": "I think probably do have what we call a simple UTI or urinary tract infection, bladder infection, um, which can be readily treated. So, I'll give you a course of antibiotics today.",
"speaker": "Doctor"
},
{
"start": 433.84102,
"end": 434.84102,
"text": "Mm-hmm.",
"speaker": "Patient"
},
{
"start": 439.50527,
"end": 440.50527,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 444.67869,
"end": 454.45894,
"text": "Something, called either Nitrofurantoin, or Trimethoprim. Uh, and it's normally a three day course. Uh, so, one tablet, twice a day, for three days.",
"speaker": "Doctor"
},
{
"start": 444.96514,
"end": 446.06733,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 454.45894,
"end": 463.15232,
"text": "And , that should hopefully help your symptoms, but I also advise you to drink plenty of fluids. Let's try and flush that, you know, that infection out of your body, if you can.",
"speaker": "Doctor"
},
{
"start": 454.717,
"end": 455.80459,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 463.15232,
"end": 476.27099,
"text": "Um, you can try, cranberry juice, that can sometimes help with your symptoms. Um, and if you're still not better, by the end of this week, I want you to give me a call or come back and see me. And uh, we can have another look at your symptoms.",
"speaker": "Doctor"
},
{
"start": 474.33752,
"end": 475.33752,
"text": "",
"speaker": "Patient"
},
{
"start": 477.14044,
"end": 484.66602,
"text": "OK, so three days of the medication, and then wait a little bit, if it still doesn't go away, call back, that OK?",
"speaker": "Patient"
},
{
"start": 477.16572,
"end": 477.9176,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 482.79731,
"end": 503.0304,
"text": "Yeah, yeah absolutely. And things to look out for would be, you know, if you are having kind of, high temperatures, a back pain, um just , generally feeling more unwell. Uh, you know, I do want you give me a call back, 'cause then we do worry whether your infection may be spreading up towards your kidneys, which is something we wanna avoid. So, do, do give me a call if you're having any concerns, OK.",
"speaker": "Doctor"
},
{
"start": 493.31569,
"end": 494.49087,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 503.38872,
"end": 510.47634,
"text": "OK, is there, is there anything like, like, should I be worried about? Like, like, not having sex or anything within the next week, or anything like this?",
"speaker": "Patient"
},
{
"start": 509.78981,
"end": 525.04736,
"text": "Yeah I mean if you can try and avoid it, I think that'd be sensible. Um, uh, it's great that you're using barrier contraception. I would recommend you to continue using barrier contraception, but if you can avoid it while your symptoms clear up. That'd probably be the best for you and your boyfriend,.",
"speaker": "Doctor"
},
{
"start": 524.80487,
"end": 531.19695,
"text": "OK, OK. Uh, that, that makes sense. Ohh, OK, thank you so much.",
"speaker": "Patient"
},
{
"start": 525.73202,
"end": 532.1432,
"text": "All right. Great. Thank you very much. Wish you all the best.",
"speaker": "Doctor"
},
{
"start": 532.34875,
"end": 534.16987,
"text": "Yeah, thank you. Take care.",
"speaker": "Patient"
},
{
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"text": "",
"speaker": "Doctor"
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],
"doctor_utterances": "Hello? Hello? I can hear you, can you hear me? . Excellent, just before I go any further, can you confirm your name and your age, please? OK. And how can I help you Mrs Smith? Right, well , I, thank you for coming in, so hopefully we can help with your symptoms. Um, so you mentioned it started a few days ago. Um, so, can you tell me a bit more about that, what kind of pain it is, that you're experiencing? , OK. And, and, uh, the pain in your tummy, is it, can you describe the , the pain to me? Is it cramping, burning, sharp? Right, right, OK, OK. Um, fine. And, have you found yourself going to the toilet more often than normal? No, OK, fine. Have you noticed any, any funny colour to your urine? So, has there been, uh, , any blood in your urine? Have you noticed any other darkening of urine? Yes. OK, fine, OK. Um, right, let me just , write a few notes down as well. Um. , and you mentioned a tummy pain, that also started a few days ago. Does the pain move anywhere else? Does it move towards the back, or towards your flank, the sides? No, OK, fine. With those symptoms, have you noticed any other symptoms like nausea, vomiting? OK. Any fevers, or temperatures? , sorry, was there any, any fevers or temperatures? Sorry, I didn't hear you. No fever, OK, fine, sorry. Um, OK. Um, in terms of your bowel, are your bowels working OK? So, uh, by that I mean, um, any, any diarrhoea, loose stool? OK, all right. And um, Jessica, sometimes we have to ask very private sensitive questions, uh, just to , get a full history. Um, hope you don't mind me asking, but are you currently sexually active? OK, is that with a regular, partner? Fine, OK. Um, have you noticed any other discharge from, from down below? No, OK. When was your last um, uh, last STD screen? If, if ever? No, OK, fine. And, and um. Do you use any form of contraception, at all? You use condoms, OK. And when was your last, period? Three weeks ago, OK. Is there any chance you could be pregnant perhaps? Is there any chance you could be pregnant? No, no. , it's always worth asking uh, young females like yourself, um. Uh, um, so if that obviously you are worried about the pain. Um, not getting any better, uh, then I'd always , advise getting a pregnancy test, to rule out pregnancy. OK? Um, fine. So just moving on, moving on. Are you otherwise fit and well? And so by that I mean, do you have any other medical problems, medical , medical history? OK. Do you take any regular medications? OK. So you've tried that and it didn't help? OK, all right. Um, do you have any allergies to any medications? And what happens when you take Clindamycin? Right then, OK. So it's quite a, seems like a quite severe allergy to it, is , is that right? Um, OK. Fine. In terms of your family history, is there anything I should be aware of, um, related to kidneys, bladder, bowels, guts? OK, all right. And tell me a bit more about your home situation. Who's lives, who's at home with you? OK, and what . OK, and are you a, are you working at the moment, or are you a student? OK, and what are you studying? And how's that going? great. Do you have any aspirations for the future, in terms of careers? , recommend it, we need doctors. Um, what about smoking and alcohol? Do you drink much in the way of, , do you, do you smoke, or do you drink much in the way of alcohol? , so socially, OK. All right. Um, right, excellent. So, um, at this stage I , I would proceed to examination. But um, based on your story, um, just to summarise really. So, last three days, you've been having bit of burning pain on passing urine. A bit of, crampy tummy pain lower down. Um, , essentially but, but no other fevers or back pain, uh, if I, if I understand correctly. I think probably do have what we call a simple UTI or urinary tract infection, bladder infection, um, which can be readily treated. So, I'll give you a course of antibiotics today. Something, called either Nitrofurantoin, or Trimethoprim. Uh, and it's normally a three day course. Uh, so, one tablet, twice a day, for three days. And , that should hopefully help your symptoms, but I also advise you to drink plenty of fluids. Let's try and flush that, you know, that infection out of your body, if you can. Um, you can try, cranberry juice, that can sometimes help with your symptoms. Um, and if you're still not better, by the end of this week, I want you to give me a call or come back and see me. And uh, we can have another look at your symptoms. OK. Yeah, yeah absolutely. And things to look out for would be, you know, if you are having kind of, high temperatures, a back pain, um just , generally feeling more unwell. Uh, you know, I do want you give me a call back, 'cause then we do worry whether your infection may be spreading up towards your kidneys, which is something we wanna avoid. So, do, do give me a call if you're having any concerns, OK. Yeah I mean if you can try and avoid it, I think that'd be sensible. Um, uh, it's great that you're using barrier contraception. I would recommend you to continue using barrier contraception, but if you can avoid it while your symptoms clear up. That'd probably be the best for you and your boyfriend,. All right. Great. Thank you very much. Wish you all the best. ",
"patient_utterances": "Hello? Hi. Can you hear me? Yeah, I can hear you now. Uh, yeah. My name is Jessica Smith, and I'm nineteen years old. Um, yeah so uh, I mean this is, this is a bit embarrassing, but it's, it's uh, hurting when I, , when I use the bathroom, when I pee. And um, it's been going on for a few days, so I'm a, I'm a little bit worried about it. Uh, not sure what to do. Um, it's, it's not too bad, it's sort of like a stinging kind of pain. Um. It's not like unbearable, but uh, it's , it's definitely uh, it definitely bothers me when I pee. Um. And uh, yeah I also maybe sometimes get some like, pain kind of lower down in my tummy, when I, when I go to the bathroom. Uh, yeah. , yeah, I don't know maybe uh, sort of, sort of cramping. I'm not really sure, but it's not like, it's not like cramping like when I get, when I have a period or something. It's like, I don't know, . Um, not, I don't think so, I haven't noticed that. Um, there was a little bit of blood earlier today, um, but besides that, not at all, no. Um. It does kind of, it, it kind of like, doesn't smell very, it smells a bit weird I guess, um, but, no, not really anything uh, anything drastic. No, not really, no. Uh, no, not , not at all. think so. No, no, no fever, no. Um, uh, I think so, yeah, it seems . Uh, no, not that I've, not that I've noticed at all. Uh, yeah I am. Ohh, yeah, so I, I've had a boyfriend for about a, a couple of months now, yeah. I haven't noticed anything. Don't think I've ever, I don't think I've ever had one. Uh, yeah, we use condoms. Uh, couple of weeks ago. Say again. Uh, I don't think so, I don't. Yeah. Uh-huh. Um, yeah, I think I'm, I'm feeling OK, otherwise, yeah. Um, so, in the past I've had some uh, some IBS. Um. But, other than that I think no like uh, real serious medical problems that seem, yeah. Uh, no, I did uh, I did uh, a little bit ago, or a couple of days ago, try some uh, over the counter bicarbonate, to try and help with the pain but it wasn't, it wasn't really helping. Uh, yeah, I'm allergic to, Clindamycin. Um, I, I get some like a, a, a swelling, basically. Yeah. Uh, no I don't think so, not that I, not anything I know about. Um, so I live in a, live in a flat near my college, with a, a couple of like friends of mine. Uh, so I'm, I'm not like living at home or anything. Um. about sorry. I'm a student. Uh, I'm studying biology. Um, it's good yeah, it's really, it's really interesting uh, learning about, learning about how uh, how the world works, yeah. Uh, I don't know, maybe a doctor someday, you never know. Uh, I don't, I don't smoke, uh, I do drink, like on the weekends, yeah. Yeah. Mm-hmm. OK. OK. OK. OK, so three days of the medication, and then wait a little bit, if it still doesn't go away, call back, that OK? OK. OK, is there, is there anything like, like, should I be worried about? Like, like, not having sex or anything within the next week, or anything like this? OK, OK. Uh, that, that makes sense. Ohh, OK, thank you so much. Yeah, thank you. Take care.",
"num_turns": 100,
"reference_note": "{\"day\": 1, \"consultation\": 9, \"presenting_complaint\": \"It hurts when I pee\", \"note\": \"3/7 hx of dysuria and suprapubic pain. Nil frequency. Brief episode of haematuria, now resolved. Foul smelling.\\nAbdo pain - cramping, nil radiating \\nNil nausea/vomiting. Nil fever. Nil bowel sx\\nCurrently sexually active - with regular partner for 2/12. No previous STD screen. Nil PV discharge. LMP 2/52 ago. \\n\\nPMH: IBS\\nDH: Nil regular \\nAllergic to clindamycin \\nFH: Nil regular \\nSH: lives in a flat with friends, student in Biology, nil smoking, social EtOH at weekends\\n\\nImp: UTI/cystitis \\n\\nPlan:\\n1.\\tNitrofurantoin abx for 3/7\\n2.\\tPush fluids\\n3.\\tTrial cranberry juice \\n4.\\tPregnancy test to exclude pregnancy \\n5.\\tReview in 3d if no better, or earlier if worsening sx (fevers, back pain, vomiting, more unwell)\\n\", \"highlights\": [\"dysuria\", \"suprapubic pain\", \"haematuria\", \"IBS\", \"UTI/cystitis\"]}",
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"consultation_id": "day1_consultation11",
"dialogue": "[Doctor] Hello?\n[Patient] Hello?\n[Doctor] Hello? Can you hear me OK?\n[Patient] Hello.\n[Patient] Uh I can hear you, but I can't really see you.\n[Doctor] That's perfect. Um\n[Patient] Is, is that OK? Am I meant to\n[Doctor] this audio. And then it's absolutely fine.\n[Patient] Just connection on the screen.\n[Doctor] Uh, now before I go any further, can I confirm your name and your age?\n[Patient] OK.\n[Patient] Um so, um my name is uh Dan Choudhry. I am seven, twenty seven.\n[Doctor] Twenty seven, OK. And how can I help you this afternoon, Dan?\n[Patient] Um so I've just um, been having some troubles, basically in the uh, I guess it's been a little while now. And I've just been feeling not so great. And It's all come from like, uh it's like basically I think it's diarrhoea. And it's like just coming out, like loads of it. Like I go to the toilet and it's just super watery and it Yeah it doesn't feel very solid. It so, it just, it's just pouring straight from my bum, and like just coming out. And it's, uh, Yeah it's just uh not, not been very pleasant. And like I just, it just kind of hasn't, doesn't feel like it's getting better. So\n[Doctor] Wow, no. Sorry to hear. Seems like there's a lot going on there. Well, when did it all start, your symptoms?\n[Patient] Um, so I think it was a few, when I think about it So Monday, Tuesday, I I, so I think it was about three, it's been about three days now.\n[Doctor] OK. And is it mainly diarrhoea? So, you mentioned watery stools. Um How many times are you going a day, would you say?\n[Patient] Um so I , I feel like it's like almost every hour, when I'm awake. Um, so . Sorry?\n[Doctor] Alright, wow. OK. So you're losing a lot of, a lot of, you're using a lot of fluid there.\n[Patient] Yeah, so I mean I'm , I'm trying to drink a lot of water. But um, yeah it's just quite a lot and Uh it's, yeah I I, I think I I feel like it's just, just fluids coming out.\n[Doctor] OK. Have you got any blood in your stools?\n[Patient] Um So I, no I don't, I don't remember anything, like, no I , I think it's just I, nothing like that. There's nothing like that.\n[Doctor] OK. And any, any tummy pain? Any, any, any pain in your tummy? \n[Patient] Yeah. I mean I, it, I feel, I feel a cramp. and then, and then I know it's time to go right? So, around every hour I just feel something come up. And then I have to go. So, yeah I mean that's, that's the , kind of the first sign.\n[Doctor] \n[Doctor] Where is this crampy pain? Which part of your tummy?\n[Patient] It's kind of, . If I think about it, it's like, it's like at the bottom. Uh, I don't know if that makes sense. Um\n[Doctor] . Well why don't we start with, is it, is it in the middle, or is it to one particular side?\n[Patient] Um I I think it it , it feels pretty , like in the middle, to me. Not on any side, left or right.\n[Doctor] OK. And does the pain come and go, or is it there constantly?\n[Patient] Um, it it comes and goes. It comes and goes.\n[Doctor] . Fine, OK. And if I was to ask you on a scale of one to ten, ten being the worst pain you ever had, how bad is this pain?\n[Patient] OK so like Um\n[Patient] So What do you mean by, uh pain? So I, I think it's maybe a\n[Doctor] Is it, is this pain as in making you double over? Is it ten, is it ten out of ten, the worst pain you ever had? Or is it more of a kind of a mild pain, like a three out of ten?\n[Patient] I I guess so. I'm, when I think about it, like when I get it, I can pretend that I don't feel it. So I can still sit down and Uh I can still like cover it up, and people don't really notice. So I, I don't know what that means. But maybe is that like a six, or a seven? \n[Doctor] solid six. OK, OK. Alright, good. Um, and apart from the pain and diarrhea, any other symptoms like nausea, vomiting?\n[Patient] OK.\n[Patient] Um, yeah I definitely, I definitely feel kind of nauseous. Um Like I and, like I've have vomited. And when I like, I think it's maybe something to do with like, whenever I have like milk or something like that, I just feel like I want to vomit. And actually, yeah one time I just like had some milk, and I just completely vomited it.\n[Doctor] Not sleeping. OK, alright. Uh\n[Patient] Um, I've been, I've been trying to avoid it. But um, yeah.\n[Doctor] And the vomiting is not as pronounced as the diarrhea. Is that right?\n[Patient] Um, sorry could you repeat that?\n[Doctor] and the vomiting is not as, uh, prominent as the diarrhea. Is that right?\n[Patient] Uh no, no it's not.\n[Doctor] OK. OK, alright. Um, any other symptoms, like fevers or temperatures?\n[Patient] Um so I, yeah I think I am pretty, I feel kind of really hot all the time. And uh I'm pretty sure I'm burning up. I haven't actually done any temperature reading, or anything like that. But it's, I, yeah I've, I've sure I'm, I'm not a, like not a normal temperature.\n[Doctor] OK.\n[Doctor] OK, so you're feeling hoarse. OK. And in terms of your waterworks, are you passing urine OK?\n[Patient] Um yeah a bit, I guess less frequently maybe. Um but yeah, it seems to be OK.\n[Doctor] OK, alright. Um, fine. And, and you said that, you mentioned, three days ago was when it all kicked off. Are you aware of any triggers? I mean, have you for example gone out, had some takeaway food? Have you been around anyone else, um with diarrhea, for example?\n[Patient] Um so I , so my um my brother has had, actually had something like this for um he has it as well for five days, as well. Um and I I've, I'm not, yeah I I can't think of what, what the trigger is for me. I mean, my brother normally can deal, deals with this stuff a lot better than me. But , yeah I, that's why\n[Doctor] Is your, is your brother now better?\n[Patient] Um He, so he's been like this for five days. I think he's getting better, but I'm not, I'm not really sure. He said, he said he had, he's had something for a little while as well.\n[Doctor] OK, alright. Are you having anything to eat or drink? Have you, I can see you're drinking a coffee, but are you keeping it down? Are you keeping your fluids down?\n[Patient] Um so it just feels like the, the fluids do go down. But it just feels like it's going straight through. It just feels like it's going straight through.\n[Doctor] OK, alright. Fine. When was the last time you had anything solid to eat? And which , which uh which you kept in?\n[Patient] Um so, I had some, I mean I had some lunch today. Um But again it just it just came, come out pretty loose.\n[Doctor] OK, alright. Um and and Dan, moving forwards, are you otherwise fit and well, or do you have any other medical history?\n[Patient] Um, so I um, yeah I think, I think otherwise I'm fit and well. I um Yeah I mean I, I'm an OK weight. And um, I I can't think of any related medical history. Um, I mean like my, yeah I no I I don't think so.\n[Doctor] Good.\n[Doctor] I'll take it you don't take any regular medications, then.\n[Patient] So I Um\n[Patient] No I mean I, I've been taking some like Paracetamols and stuff like that lately. But uh, I haven't been, I'm not on any regular medication or anything like that.\n[Doctor] OK. And do you have any allergies to any medications?\n[Patient] Um, so I don't have any allergies that I know of.\n[Doctor] OK. And what about any family history? Do you have any family history of bowel problems? \n[Patient] Um bowel, so would, would bowel like, is is the colon like something that\n[Doctor] Yeah, yeah. So what I mean by bowel is the whole gut. So it could be anything from the mouth anus.\n[Patient] So my, yeah my, my dad actually has um colon cancer at the moment.\n[Doctor] Ohh dear. I'm very sorry to hear that. How is he?\n[Patient] So um, from what I heard he's kind of, So I don't I don't speak to him that often. So I don't, I don't know the exact details. And I, I don't exactly know the full things of like the steps of cancer, and all that kind of thing. But um, he's sort of in his third stage. Uh, I'm not sure what that means exactly.\n[Doctor] \n[Patient] Um, and yeah. So yeah it's, it's um, he's, yeah you can, yeah I can see he's kind of weaker, and it's affecting him a lot. And um, that's it's quite, I I guess he's um, had it for a little while now.\n[Doctor] Yeah, OK.\n[Doctor] \n[Doctor] Yeah I'll make a not of that 'cause uh, important to know these kind of details. Um, and socially, tell me more about your home situation. Who's at home with you, Dan?\n[Patient] Um so, uh not my brother. He doesn't live with me. I'm, I live with my, um sister and my mum.\n[Doctor] OK. And, uh, how are things at home?\n[Patient] Um, I think, I mean in what sense do you mean that?\n[Doctor] Don't . in general day-to-day life are you managing OK? Any particular ?\n[Patient] I mean uh I think uh, yeah it's been, it's been tricky. Um Going to work with all of this. Um I dislike um, taking time off work. I feel like I I just want to go, um when I can. So I I try and go um I think at, at home, uh yeah I just haven't really um I I don't normally actually um, eat with my family. I normally am buying stuff and that kind of thing. So, I don't think it's affected them. And I haven't really been, haven't really gone into detail with my sister and my mom about it. Um Yeah. I'd, I'd just rather deal with these things. Um so \n[Doctor] Sure. you mentioned work. You mentioned work. What is it you do for work?\n[Patient] Um So I work at a, I I work at um an office, um in Central London. Um it's uh, so I work in government.\n[Doctor] , OK. So , OK right. And just a couple last final couple, uh couple questions. Uh, smoking and alcohol, do you do either? Do you smoke, or do you drink much in the way of alcohol?\n[Patient] Um so I I smoke um, I smoke uh, uh for like socially, but not like regularly. Um So normally if if it's a, a Friday or something like that I might, I might have a cigarette or something like that. But um not .\n[Doctor] \n[Patient] Sorry?\n[Doctor] And alcohol?\n[Patient] So alcohol, um uh you know I might have a a beer during the weekdays, maybe uh not that many, maybe um . On Fridays I have more um alcohol um\n[Doctor] But not .\n[Patient] But yeah uh, I'll have my units um\n[Doctor] \n[Patient] Uh, honest, I suppose um, not every week, but maybe I'll once or twice a month, that yeah, I'll go out with my friends and drink a lot so that that's um, yeah um\n[Doctor] \n[Doctor] Well thank you for me. That's really helpful to know. So um, Dan, just as a a conclusion, uh um, just to wrap it all up, I think your symptoms are suggestive of something called gastroenteritis.\n[Patient] OK.\n[Doctor] bit of a basic infection of your tummy. . There's nothing to worry about. Uh um uh uh I suspect this will just settle down in the next few days.\n[Patient] OK.\n[Doctor] Just like you did for you brother. Drink, make sure you drink plenty of fluids, OK? And you can \n[Patient] Uh-huh.\n[Patient] Should I just drink like normal water? I just feel like every time I drink it's just coming out. Um \n[Doctor] Right. fluid is probably best. But I am obviously worried about the fact that you are losing minerals and vitamins. Um so, you can get things like Diarolyte, which is um, a fluid replacement you can get from the pharmacy. It's probably worth uh recommending that.\n[Patient] Do i need like a prescription for that?\n[Doctor] no, you can just get that over the counter.\n[Patient] OK.\n[Doctor] Um, you can try just you know regular Paracetamol if you are feeling feverish. But if your symptoms aren't settling down in the next couple of days, so forty eight hours, I want you to give me a call back.\n[Patient] \n[Doctor] Because um, you know if you are getting dehydrated then we need to do further investigations, OK? But I think let's, let's see how you are in the next one to two days.\n[Patient] OK.\n[Doctor] And uh, we'll catch up soon, OK?\n[Patient] OK. So you're saying that I should, I could, uh I'll try and buy this Dioralyte. What, what should I do in terms of um, food and that kind of thing? Should I just focus on fluids?\n[Doctor] clear fluids. You can use soft diet, things like soup, mash. And then gradually build up, um as much as your body can tolerate. Um, but let's try and keep yourself well-hydrated first, OK?\n[Patient] OK. Is it OK for me to carry on having like, um Paracetamol and things like that?\n[Doctor] Absolutely. If you are having, if you've got a bit of tummy pain, if you're feeling feverish, then I think Paracetamol is very sensible.\n[Patient] OK.\n[Doctor] OK? Try and avoid alcohol if you can.\n[Patient] Uh, OK I'll try. Yeah.\n[Doctor] OK. Alright then.\n[Patient] OK.\n[Doctor] Thank you for your help.\n[Patient] Alright. Thank you very much. Thanks, thanks for helping me out.\n[Doctor] . Thank you. Bye bye now.\n[Patient] K. Bye.",
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"text": "Uh, now before I go any further, can I confirm your name and your age?",
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"text": "Twenty seven, OK. And how can I help you this afternoon, Dan?",
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"text": "Um so I've just um, been having some troubles, basically in the uh, I guess it's been a little while now. And I've just been feeling not so great. And It's all come from like, uh it's like basically I think it's diarrhoea. And it's like just coming out, like loads of it. Like I go to the toilet and it's just super watery and it Yeah it doesn't feel very solid. It so, it just, it's just pouring straight from my bum, and like just coming out. And it's, uh, Yeah it's just uh not, not been very pleasant. And like I just, it just kind of hasn't, doesn't feel like it's getting better. So",
"speaker": "Patient"
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"text": "Wow, no. Sorry to hear. Seems like there's a lot going on there. Well, when did it all start, your symptoms?",
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"text": "Um, so I think it was a few, when I think about it So Monday, Tuesday, I I, so I think it was about three, it's been about three days now.",
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"text": "OK. And is it mainly diarrhoea? So, you mentioned watery stools. Um How many times are you going a day, would you say?",
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"text": "Um so I , I feel like it's like almost every hour, when I'm awake. Um, so . Sorry?",
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"text": "Alright, wow. OK. So you're losing a lot of, a lot of, you're using a lot of fluid there.",
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"text": "Yeah, so I mean I'm , I'm trying to drink a lot of water. But um, yeah it's just quite a lot and Uh it's, yeah I I, I think I I feel like it's just, just fluids coming out.",
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"text": "Um So I, no I don't, I don't remember anything, like, no I , I think it's just I, nothing like that. There's nothing like that.",
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"text": "OK. And any, any tummy pain? Any, any, any pain in your tummy? ",
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"text": "Yeah. I mean I, it, I feel, I feel a cramp. and then, and then I know it's time to go right? So, around every hour I just feel something come up. And then I have to go. So, yeah I mean that's, that's the , kind of the first sign.",
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"text": "It's kind of, . If I think about it, it's like, it's like at the bottom. Uh, I don't know if that makes sense. Um",
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"text": "I I guess so. I'm, when I think about it, like when I get it, I can pretend that I don't feel it. So I can still sit down and Uh I can still like cover it up, and people don't really notice. So I, I don't know what that means. But maybe is that like a six, or a seven? ",
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"text": " solid six. OK, OK. Alright, good. Um, and apart from the pain and diarrhea, any other symptoms like nausea, vomiting?",
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"text": "Um, yeah I definitely, I definitely feel kind of nauseous. Um Like I and, like I've have vomited. And when I like, I think it's maybe something to do with like, whenever I have like milk or something like that, I just feel like I want to vomit. And actually, yeah one time I just like had some milk, and I just completely vomited it.",
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"text": "And the vomiting is not as pronounced as the diarrhea. Is that right?",
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"text": "OK, so you're feeling hoarse. OK. And in terms of your waterworks, are you passing urine OK?",
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"text": "Um yeah a bit, I guess less frequently maybe. Um but yeah, it seems to be OK.",
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"text": "OK, alright. Um, fine. And, and you said that, you mentioned, three days ago was when it all kicked off. Are you aware of any triggers? I mean, have you for example gone out, had some takeaway food? Have you been around anyone else, um with diarrhea, for example?",
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"text": "Um so I , so my um my brother has had, actually had something like this for um he has it as well for five days, as well. Um and I I've, I'm not, yeah I I can't think of what, what the trigger is for me. I mean, my brother normally can deal, deals with this stuff a lot better than me. But , yeah I, that's why",
"speaker": "Patient"
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"text": "Um He, so he's been like this for five days. I think he's getting better, but I'm not, I'm not really sure. He said, he said he had, he's had something for a little while as well.",
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"text": "Um so it just feels like the, the fluids do go down. But it just feels like it's going straight through. It just feels like it's going straight through.",
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"text": "OK, alright. Fine. When was the last time you had anything solid to eat? And which , which uh which you kept in?",
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"text": "Um so, I had some, I mean I had some lunch today. Um But again it just it just came, come out pretty loose.",
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"text": "OK, alright. Um and and Dan, moving forwards, are you otherwise fit and well, or do you have any other medical history?",
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"text": "Um, so I um, yeah I think, I think otherwise I'm fit and well. I um Yeah I mean I, I'm an OK weight. And um, I I can't think of any related medical history. Um, I mean like my, yeah I no I I don't think so.",
"speaker": "Patient"
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"text": "Good.",
"speaker": "Doctor"
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"text": "I'll take it you don't take any regular medications, then.",
"speaker": "Doctor"
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"text": "So I Um",
"speaker": "Patient"
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"text": "No I mean I, I've been taking some like Paracetamols and stuff like that lately. But uh, I haven't been, I'm not on any regular medication or anything like that.",
"speaker": "Patient"
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"text": "OK. And do you have any allergies to any medications?",
"speaker": "Doctor"
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"text": "Um, so I don't have any allergies that I know of.",
"speaker": "Patient"
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"text": "OK. And what about any family history? Do you have any family history of bowel problems? ",
"speaker": "Doctor"
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"start": 462.17579,
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"text": "Um bowel, so would, would bowel like, is is the colon like something that",
"speaker": "Patient"
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{
"start": 466.55297,
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"text": "Yeah, yeah. So what I mean by bowel is the whole gut. So it could be anything from the mouth anus.",
"speaker": "Doctor"
},
{
"start": 469.65695,
"end": 477.81251,
"text": " So my, yeah my, my dad actually has um colon cancer at the moment.",
"speaker": "Patient"
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{
"start": 477.66471,
"end": 480.51764,
"text": "Ohh dear. I'm very sorry to hear that. How is he?",
"speaker": "Doctor"
},
{
"start": 480.88476,
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"text": "So um, from what I heard he's kind of, So I don't I don't speak to him that often. So I don't, I don't know the exact details. And I, I don't exactly know the full things of like the steps of cancer, and all that kind of thing. But um, he's sort of in his third stage. Uh, I'm not sure what that means exactly.",
"speaker": "Patient"
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"speaker": "Doctor"
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"text": "Um, and yeah. So yeah it's, it's um, he's, yeah you can, yeah I can see he's kind of weaker, and it's affecting him a lot. And um, that's it's quite, I I guess he's um, had it for a little while now.",
"speaker": "Patient"
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"text": "Yeah, OK.",
"speaker": "Doctor"
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"text": " Yeah I'll make a not of that 'cause uh, important to know these kind of details. Um, and socially, tell me more about your home situation. Who's at home with you, Dan?",
"speaker": "Doctor"
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"text": "Um so, uh not my brother. He doesn't live with me. I'm, I live with my, um sister and my mum.",
"speaker": "Patient"
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"text": "OK. And, uh, how are things at home?",
"speaker": "Doctor"
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"text": "Um, I think, I mean in what sense do you mean that?",
"speaker": "Patient"
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{
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"text": "Don't . in general day-to-day life are you managing OK? Any particular ?",
"speaker": "Doctor"
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"text": " I mean uh I think uh, yeah it's been, it's been tricky. Um Going to work with all of this. Um I dislike um, taking time off work. I feel like I I just want to go, um when I can. So I I try and go um I think at, at home, uh yeah I just haven't really um I I don't normally actually um, eat with my family. I normally am buying stuff and that kind of thing. So, I don't think it's affected them. And I haven't really been, haven't really gone into detail with my sister and my mom about it. Um Yeah. I'd, I'd just rather deal with these things. Um so ",
"speaker": "Patient"
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"text": "Sure. you mentioned work. You mentioned work. What is it you do for work?",
"speaker": "Doctor"
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{
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"text": "Um So I work at a, I I work at um an office, um in Central London. Um it's uh, so I work in government.",
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"text": ", OK. So , OK right. And just a couple last final couple, uh couple questions. Uh, smoking and alcohol, do you do either? Do you smoke, or do you drink much in the way of alcohol?",
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"text": "Um so I I smoke um, I smoke uh, uh for like socially, but not like regularly. Um So normally if if it's a, a Friday or something like that I might, I might have a cigarette or something like that. But um not .",
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"text": "Sorry?",
"speaker": "Patient"
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"text": "And alcohol?",
"speaker": "Doctor"
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"text": "So alcohol, um uh you know I might have a a beer during the weekdays, maybe uh not that many, maybe um . On Fridays I have more um alcohol um",
"speaker": "Patient"
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"text": " But not .",
"speaker": "Doctor"
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"text": "But yeah uh, I'll have my units um",
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"text": "Uh, honest, I suppose um, not every week, but maybe I'll once or twice a month, that yeah, I'll go out with my friends and drink a lot so that that's um, yeah um",
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"text": "Well thank you for me. That's really helpful to know. So um, Dan, just as a a conclusion, uh um, just to wrap it all up, I think your symptoms are suggestive of something called gastroenteritis.",
"speaker": "Doctor"
},
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"start": 686.24621,
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"text": "OK.",
"speaker": "Patient"
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"text": "bit of a basic infection of your tummy. . There's nothing to worry about. Uh um uh uh I suspect this will just settle down in the next few days.",
"speaker": "Doctor"
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"text": "OK.",
"speaker": "Patient"
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"text": "Just like you did for you brother. Drink, make sure you drink plenty of fluids, OK? And you can ",
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"text": "Uh-huh.",
"speaker": "Patient"
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"text": "Should I just drink like normal water? I just feel like every time I drink it's just coming out. Um ",
"speaker": "Patient"
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{
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"end": 722.18242,
"text": "Right. fluid is probably best. But I am obviously worried about the fact that you are losing minerals and vitamins. Um so, you can get things like Diarolyte, which is um, a fluid replacement you can get from the pharmacy. It's probably worth uh recommending that.",
"speaker": "Doctor"
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"text": " Do i need like a prescription for that?",
"speaker": "Patient"
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"text": " no, you can just get that over the counter.",
"speaker": "Doctor"
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"end": 726.55787,
"text": "OK.",
"speaker": "Patient"
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{
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"text": "Um, you can try just you know regular Paracetamol if you are feeling feverish. But if your symptoms aren't settling down in the next couple of days, so forty eight hours, I want you to give me a call back.",
"speaker": "Doctor"
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"speaker": "Patient"
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"text": "Because um, you know if you are getting dehydrated then we need to do further investigations, OK? But I think let's, let's see how you are in the next one to two days.",
"speaker": "Doctor"
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"text": "OK.",
"speaker": "Patient"
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{
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"text": "And uh, we'll catch up soon, OK?",
"speaker": "Doctor"
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"text": "OK. So you're saying that I should, I could, uh I'll try and buy this Dioralyte. What, what should I do in terms of um, food and that kind of thing? Should I just focus on fluids?",
"speaker": "Patient"
},
{
"start": 756.55916,
"end": 771.45762,
"text": " clear fluids. You can use soft diet, things like soup, mash. And then gradually build up, um as much as your body can tolerate. Um, but let's try and keep yourself well-hydrated first, OK?",
"speaker": "Doctor"
},
{
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"text": "OK. Is it OK for me to carry on having like, um Paracetamol and things like that?",
"speaker": "Patient"
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"text": "Absolutely. If you are having, if you've got a bit of tummy pain, if you're feeling feverish, then I think Paracetamol is very sensible.",
"speaker": "Doctor"
},
{
"start": 783.3614,
"end": 783.9864,
"text": "OK.",
"speaker": "Patient"
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{
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"text": "OK? Try and avoid alcohol if you can.",
"speaker": "Doctor"
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"text": "Uh, OK I'll try. Yeah.",
"speaker": "Patient"
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{
"start": 790.01641,
"end": 791.33508,
"text": "OK. Alright then.",
"speaker": "Doctor"
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{
"start": 793.14142,
"end": 793.83055,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 793.81186,
"end": 794.84789,
"text": "Thank you for your help.",
"speaker": "Doctor"
},
{
"start": 795.08785,
"end": 798.84921,
"text": "Alright. Thank you very much. Thanks, thanks for helping me out.",
"speaker": "Patient"
},
{
"start": 796.29394,
"end": 799.73904,
"text": ". Thank you. Bye bye now.",
"speaker": "Doctor"
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{
"start": 800.3622,
"end": 801.53184,
"text": "K. Bye.",
"speaker": "Patient"
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],
"doctor_utterances": "Hello? Hello? Can you hear me OK? That's perfect. Um this audio. And then it's absolutely fine. Uh, now before I go any further, can I confirm your name and your age? Twenty seven, OK. And how can I help you this afternoon, Dan? Wow, no. Sorry to hear. Seems like there's a lot going on there. Well, when did it all start, your symptoms? OK. And is it mainly diarrhoea? So, you mentioned watery stools. Um How many times are you going a day, would you say? Alright, wow. OK. So you're losing a lot of, a lot of, you're using a lot of fluid there. OK. Have you got any blood in your stools? OK. And any, any tummy pain? Any, any, any pain in your tummy? Where is this crampy pain? Which part of your tummy? . Well why don't we start with, is it, is it in the middle, or is it to one particular side? OK. And does the pain come and go, or is it there constantly? . Fine, OK. And if I was to ask you on a scale of one to ten, ten being the worst pain you ever had, how bad is this pain? Is it, is this pain as in making you double over? Is it ten, is it ten out of ten, the worst pain you ever had? Or is it more of a kind of a mild pain, like a three out of ten? solid six. OK, OK. Alright, good. Um, and apart from the pain and diarrhea, any other symptoms like nausea, vomiting? Not sleeping. OK, alright. Uh And the vomiting is not as pronounced as the diarrhea. Is that right? and the vomiting is not as, uh, prominent as the diarrhea. Is that right? OK. OK, alright. Um, any other symptoms, like fevers or temperatures? OK. OK, so you're feeling hoarse. OK. And in terms of your waterworks, are you passing urine OK? OK, alright. Um, fine. And, and you said that, you mentioned, three days ago was when it all kicked off. Are you aware of any triggers? I mean, have you for example gone out, had some takeaway food? Have you been around anyone else, um with diarrhea, for example? Is your, is your brother now better? OK, alright. Are you having anything to eat or drink? Have you, I can see you're drinking a coffee, but are you keeping it down? Are you keeping your fluids down? OK, alright. Fine. When was the last time you had anything solid to eat? And which , which uh which you kept in? OK, alright. Um and and Dan, moving forwards, are you otherwise fit and well, or do you have any other medical history? Good. I'll take it you don't take any regular medications, then. OK. And do you have any allergies to any medications? OK. And what about any family history? Do you have any family history of bowel problems? Yeah, yeah. So what I mean by bowel is the whole gut. So it could be anything from the mouth anus. Ohh dear. I'm very sorry to hear that. How is he? Yeah, OK. Yeah I'll make a not of that 'cause uh, important to know these kind of details. Um, and socially, tell me more about your home situation. Who's at home with you, Dan? OK. And, uh, how are things at home? Don't . in general day-to-day life are you managing OK? Any particular ? Sure. you mentioned work. You mentioned work. What is it you do for work? , OK. So , OK right. And just a couple last final couple, uh couple questions. Uh, smoking and alcohol, do you do either? Do you smoke, or do you drink much in the way of alcohol? And alcohol? But not . Well thank you for me. That's really helpful to know. So um, Dan, just as a a conclusion, uh um, just to wrap it all up, I think your symptoms are suggestive of something called gastroenteritis. bit of a basic infection of your tummy. . There's nothing to worry about. Uh um uh uh I suspect this will just settle down in the next few days. Just like you did for you brother. Drink, make sure you drink plenty of fluids, OK? And you can Right. fluid is probably best. But I am obviously worried about the fact that you are losing minerals and vitamins. Um so, you can get things like Diarolyte, which is um, a fluid replacement you can get from the pharmacy. It's probably worth uh recommending that. no, you can just get that over the counter. Um, you can try just you know regular Paracetamol if you are feeling feverish. But if your symptoms aren't settling down in the next couple of days, so forty eight hours, I want you to give me a call back. Because um, you know if you are getting dehydrated then we need to do further investigations, OK? But I think let's, let's see how you are in the next one to two days. And uh, we'll catch up soon, OK? clear fluids. You can use soft diet, things like soup, mash. And then gradually build up, um as much as your body can tolerate. Um, but let's try and keep yourself well-hydrated first, OK? Absolutely. If you are having, if you've got a bit of tummy pain, if you're feeling feverish, then I think Paracetamol is very sensible. OK? Try and avoid alcohol if you can. OK. Alright then. Thank you for your help. . Thank you. Bye bye now.",
"patient_utterances": "Hello? Hello. Uh I can hear you, but I can't really see you. Is, is that OK? Am I meant to Just connection on the screen. OK. Um so, um my name is uh Dan Choudhry. I am seven, twenty seven. Um so I've just um, been having some troubles, basically in the uh, I guess it's been a little while now. And I've just been feeling not so great. And It's all come from like, uh it's like basically I think it's diarrhoea. And it's like just coming out, like loads of it. Like I go to the toilet and it's just super watery and it Yeah it doesn't feel very solid. It so, it just, it's just pouring straight from my bum, and like just coming out. And it's, uh, Yeah it's just uh not, not been very pleasant. And like I just, it just kind of hasn't, doesn't feel like it's getting better. So Um, so I think it was a few, when I think about it So Monday, Tuesday, I I, so I think it was about three, it's been about three days now. Um so I , I feel like it's like almost every hour, when I'm awake. Um, so . Sorry? Yeah, so I mean I'm , I'm trying to drink a lot of water. But um, yeah it's just quite a lot and Uh it's, yeah I I, I think I I feel like it's just, just fluids coming out. Um So I, no I don't, I don't remember anything, like, no I , I think it's just I, nothing like that. There's nothing like that. Yeah. I mean I, it, I feel, I feel a cramp. and then, and then I know it's time to go right? So, around every hour I just feel something come up. And then I have to go. So, yeah I mean that's, that's the , kind of the first sign. It's kind of, . If I think about it, it's like, it's like at the bottom. Uh, I don't know if that makes sense. Um Um I I think it it , it feels pretty , like in the middle, to me. Not on any side, left or right. Um, it it comes and goes. It comes and goes. OK so like Um So What do you mean by, uh pain? So I, I think it's maybe a I I guess so. I'm, when I think about it, like when I get it, I can pretend that I don't feel it. So I can still sit down and Uh I can still like cover it up, and people don't really notice. So I, I don't know what that means. But maybe is that like a six, or a seven? OK. Um, yeah I definitely, I definitely feel kind of nauseous. Um Like I and, like I've have vomited. And when I like, I think it's maybe something to do with like, whenever I have like milk or something like that, I just feel like I want to vomit. And actually, yeah one time I just like had some milk, and I just completely vomited it. Um, I've been, I've been trying to avoid it. But um, yeah. Um, sorry could you repeat that? Uh no, no it's not. Um so I, yeah I think I am pretty, I feel kind of really hot all the time. And uh I'm pretty sure I'm burning up. I haven't actually done any temperature reading, or anything like that. But it's, I, yeah I've, I've sure I'm, I'm not a, like not a normal temperature. Um yeah a bit, I guess less frequently maybe. Um but yeah, it seems to be OK. Um so I , so my um my brother has had, actually had something like this for um he has it as well for five days, as well. Um and I I've, I'm not, yeah I I can't think of what, what the trigger is for me. I mean, my brother normally can deal, deals with this stuff a lot better than me. But , yeah I, that's why Um He, so he's been like this for five days. I think he's getting better, but I'm not, I'm not really sure. He said, he said he had, he's had something for a little while as well. Um so it just feels like the, the fluids do go down. But it just feels like it's going straight through. It just feels like it's going straight through. Um so, I had some, I mean I had some lunch today. Um But again it just it just came, come out pretty loose. Um, so I um, yeah I think, I think otherwise I'm fit and well. I um Yeah I mean I, I'm an OK weight. And um, I I can't think of any related medical history. Um, I mean like my, yeah I no I I don't think so. So I Um No I mean I, I've been taking some like Paracetamols and stuff like that lately. But uh, I haven't been, I'm not on any regular medication or anything like that. Um, so I don't have any allergies that I know of. Um bowel, so would, would bowel like, is is the colon like something that So my, yeah my, my dad actually has um colon cancer at the moment. So um, from what I heard he's kind of, So I don't I don't speak to him that often. So I don't, I don't know the exact details. And I, I don't exactly know the full things of like the steps of cancer, and all that kind of thing. But um, he's sort of in his third stage. Uh, I'm not sure what that means exactly. Um, and yeah. So yeah it's, it's um, he's, yeah you can, yeah I can see he's kind of weaker, and it's affecting him a lot. And um, that's it's quite, I I guess he's um, had it for a little while now. Um so, uh not my brother. He doesn't live with me. I'm, I live with my, um sister and my mum. Um, I think, I mean in what sense do you mean that? I mean uh I think uh, yeah it's been, it's been tricky. Um Going to work with all of this. Um I dislike um, taking time off work. I feel like I I just want to go, um when I can. So I I try and go um I think at, at home, uh yeah I just haven't really um I I don't normally actually um, eat with my family. I normally am buying stuff and that kind of thing. So, I don't think it's affected them. And I haven't really been, haven't really gone into detail with my sister and my mom about it. Um Yeah. I'd, I'd just rather deal with these things. Um so Um So I work at a, I I work at um an office, um in Central London. Um it's uh, so I work in government. Um so I I smoke um, I smoke uh, uh for like socially, but not like regularly. Um So normally if if it's a, a Friday or something like that I might, I might have a cigarette or something like that. But um not . Sorry? So alcohol, um uh you know I might have a a beer during the weekdays, maybe uh not that many, maybe um . On Fridays I have more um alcohol um But yeah uh, I'll have my units um Uh, honest, I suppose um, not every week, but maybe I'll once or twice a month, that yeah, I'll go out with my friends and drink a lot so that that's um, yeah um OK. OK. Uh-huh. Should I just drink like normal water? I just feel like every time I drink it's just coming out. Um Do i need like a prescription for that? OK. OK. OK. So you're saying that I should, I could, uh I'll try and buy this Dioralyte. What, what should I do in terms of um, food and that kind of thing? Should I just focus on fluids? OK. Is it OK for me to carry on having like, um Paracetamol and things like that? OK. Uh, OK I'll try. Yeah. OK. Alright. Thank you very much. Thanks, thanks for helping me out. K. Bye.",
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"reference_note": "{\"day\": 1, \"consultation\": 11, \"presenting_complaint\": \"pouring diarrhoea from my bottom\", \"note\": \"3/7 hx of diarrhea - watery stools, opening bowels every hour. No blood in stools. Assoc crampy abdo pain - central, intermittent, severity 6/10. Feels nauseous, has vomited occasionally. Feeling feverish, hot/cold\\nNil urinary sx - passing less urine . no weight loss. \\nBrother also had similar sx - improving \\nTolerating oral intake \\n\\nPMH: nil\\nDH: nil regular \\nNKDA\\nFH: father - colon Ca \\nSH: lives with sister and mum. Works in office. Smokes socially, EtOH - socially \\n\\nImp: gastroenteritis \\n\\nPlan:\\n1.\\tPush fluids \\n2.\\tOTC diarolyte \\n3.\\tEncourage soft diet\\n4.\\tRegular paracetamol \\n5.\\tReview in 48 hours, or earlier if worsening sx\\n\\n\", \"highlights\": [\"diarrhea\", \"crampy abdo pain\", \"vomited\", \"feverish\", \"hot/cold\", \"father - colon Ca\", \"gastroenteritis\"]}",
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"dialogue": "[Doctor] There's no . , hello?\n[Patient] . Hi there.\n[Doctor] Hello there. Um, thanks for, thanks for, being here. Um, before I go any further, can I uh, confirm your name and your age please?\n[Patient] Yes, it's um Adriana Katherine . And I'm twenty six year old.\n[Doctor] \n[Doctor] OK, Adriana, and how can I help you this afternoon?\n[Patient] Well, I have this like really crazy headache that's been going on for a few days. And it really annoys me.\n[Doctor] Ohh dear, OK. , when, when did it exactly start, this headache?\n[Patient] Eh, around three days ago, maybe.\n[Doctor] Three days ago, OK. And whereabout in your head, is this pain?\n[Patient] Um, it's basically like, it kind of feels all over my head, but like mainly, um, around my right eye. Um\n[Doctor] , OK. Um, and is the, headache there all the time, or does it come and go?\n[Patient] Um it's, it kind of comes and goes. Um but, I mean it is there all the time, but like sometimes it's stronger.\n[Doctor] OK, so it comes and, fine, OK. And if I was to ask you on a scale of one to ten, um, ten being the worst type of pain you ever had. How would you rate this headache?\n[Patient] Ohh it's probably a eight.\n[Doctor] Eight. And if I was to ask you describe the headache to me, um, in terms of the nature of the pain. Is it sharp? Is it dull? Is it crampy? Is it throbbing?\n[Patient] Um, it's kind of, it's dull but sometimes it gets a bit sharper. So basically it like, it developed gradually, I guess. It's like the first day it just started when I was at work.\n[Doctor] Mm-hmm.\n[Patient] And by the end of the day it was like pretty, pretty, like it was a lot, basically. And then I was thinking OK, maybe I'll just go to sleep. And when I woke up the next morning like, it was even, even worse basically. So\n[Doctor] Mm-hmm.\n[Doctor] So, you think the headache is getting worse over the last three days?\n[Patient] Yeah.\n[Doctor] OK. Have you tried anything which has made the headache better?\n[Patient] Um so I tried uh Ibuprofen. Um so I took, like a few. Um for the last two days, basically.\n[Doctor] Did that help?\n[Patient] But it doesn't really help, no. In in the past it did help me, which is why I decided to try it. But\n[Doctor] OK, all right. And except for the headaches, any other symptoms at all?\n[Patient] Um\n[Doctor] So, example any, problems your eyesight or your vision?\n[Patient] Not really, but just when it started, I I got this like weird shooting lights. And like now like light is quite annoying, my eyes.\n[Doctor] So when you say annoying, does it hurt to look, uh, look at bright lights?\n[Patient] Yeah, yeah. It hurts. So\n[Doctor] , OK. And um, have you had any loss of vision or blurry vision?\n[Patient] Not loss of vision, I wouldn't say. It's just like some lights from, shooting lights .\n[Doctor] Mmm, , OK. Any nausea or any vomiting?\n[Patient] Um, well I'm like basically, I I'm sick with the headache. But I, no vomiting.\n[Doctor] When you say sick, you mean you feel sick? OK. Yeah, no vomiting, OK. Any neck pain or neck stiffness?\n[Patient] Yeah.\n[Patient] No.\n[Doctor] OK. And any difficulty with speaking or, um, speech?\n[Patient] No.\n[Doctor] Any difficulty , with weakness in your arms and legs?\n[Patient] No, it's hard to focus though. So, I I had to take a couple of days off work, actually.\n[Doctor] Ohh really? OK. OK, yeah probably, well I'll, I'll ask you a bit more about your work later on. Um, any recent head injuries at all?\n[Patient] Uh, no.\n[Doctor] OK. And have you had anything like this before in the past?\n[Patient] Yeah I mean, headaches, you mean.\n[Doctor] Or, uh, or similar, similar to, similar to this kind of headache, ?\n[Patient] Yeah. I mean I had. But, usually after I I take uh Ibuprofen it kind of goes away. So, but this time it's just not. .\n[Doctor] not, OK. All right. Um, any temperatures, or fevers?\n[Patient] No.\n[Doctor] Any rashes at all, on your skin?\n[Patient] Mm, no not that I've noticed.\n[Doctor] OK. And just moving forwards. Are you otherwise fit and well, Adriana?\n[Patient] Am I what, sorry?\n[Doctor] You fit and well? , do you have any other medical history?\n[Patient] Yeah, I think so. It's just the headache.\n[Doctor] Any history of migraines at all?\n[Patient] Not myself, I've never had a migraine. But my sister and my mom have them quite frequently.\n[Doctor] OK. Um, fine. I'll ask you a bit more about that in just a second. Before I go any further, can I ask, do you take any regular medication?\n[Patient] Uh, no no.\n[Doctor] Are you on the pill?\n[Doctor] OK. Do you have any allergies to any medications?\n[Patient] Mm not that I know of.\n[Doctor] OK. So you mentioned your mother and sister both have migraines.\n[Patient] Yeah.\n[Doctor] Are they, is that normally well-controlled or are they um, having difficulty, controlling their symptoms?\n[Patient] Um so my sister's, like better. Like it's kind of, it's very rare. But my mom's is like quite bad, um usually when there's like a season changing and stuff like that. It's, yeah.\n[Doctor] Mm-hmm, OK.\n[Patient] Takes her out for a few days, basically.\n[Doctor] Ohh right, OK, fine. Um, socially, tell me a bit more about your life, outside of, um, outside of, work. So , who lives at home with you?\n[Patient] Uh I live with housemates. So, three of them. So we're four .\n[Doctor] OK. Excellent. And are you working at the moment? You mentioned this , impacting on your work.\n[Patient] Yeah so I work, well I work in IT. So I work with computers a lot. So it kind of is difficult to focus. Um I had to like reduce the uh, brightness of my screen.\n[Doctor] Mmm. OK. Do you wear glasses?\n[Patient] Yes, I do.\n[Doctor] Have you had any, uh, have you had any recent eye check, done? Eye test?\n[Patient] No, uh I've been wearing them since I was five , five year old. So, it's quite a long time.\n[Doctor] OK, all right. Something for you to bear in mind if you feel that you are, your eyes are straining. Um I would always recommend having a repeat eye test done. Um, have you been feeling more stressed or anxious at work recently?\n[Patient] \n[Patient] Well, it's been a bit stressful, kicking off a new project. But um, yeah nothing out of the ordinary, really.\n[Doctor] OK, all right. Great. Um, regarding smoking or alcohol. Do you drink or smoke at all?\n[Patient] I socially smoke. And I drink only socially.\n[Doctor] But only socially? OK. Right. Now um, Adriana, do you have any ideas as to what could be causing your symptoms? Have you, have you read anything online, or spoken to people?\n[Patient] Um Not really. Um at first I thought it's stress, or maybe I didn't drink enough water. Because sometimes when I don't drink enough water, I I like get headaches. Um\n[Doctor] Mm-hmm.\n[Patient] But, I don't think that's it. And I'm like worried, it's, I don't want it to be a migraine. Because I know what it's like, from my mom and my sister.\n[Doctor] \n[Doctor] Mmm.\n[Patient] And it's really annoying. So I I really don't want to have that. And I know it's genetic. So I've researched that. Um but I don't know if that is the case. So, yeah.\n[Doctor] OK. Is it anything in particular you were hoping I could do for you today?\n[Patient] Yeah maybe just kinda, if you have any recommendations of that I can take something stronger. Because apparently, Ibuprofen doesn't help me. Uh\n[Doctor] OK.\n[Patient] Usually it gets resolved if I have headache in like, after like one or two days. But currently it, it didn't help me.\n[Doctor] How many tablets did you take of Ibuprofen?\n[Patient] Uh, three a day.\n[Doctor] Three a day, OK. All right. Um, so uh, Adriana, so um, really what I think is going on here. I , uh, unfortunately I do think this could be, a headache very similar to a migraine.\n[Patient] \n[Doctor] Um, the reason I say that is because the history is very suggestive of it, given your mum and your sister also migraines. I think it's something for us to think about. Um, now I'm not saying it's gonna, keep happening, but, it may just be a one-off. But it's certainly worth treating it today stronger analgesia or painkillers. Um, now moving forward, we have some options which we can discuss. Uh, you tried the Ibuprofen. Now, my only worry is, I'm not sure whether you're taking, the correct dose. You can take up to two tablets, three times a day.\n[Patient] Ohh right.\n[Doctor] So, so , there's definitely room for, improvement there. Or, I can prescribe you something stronger, like Naproxen, which is another anti-inflammatory, which can be helpful.\n[Patient] Mm-hmm.\n[Doctor] Um, we can also add in other, painkillers like, Paracetamol, or Codeine. Which might be helpful as well.\n[Patient] Mm, yeah. I think is what my mom takes for when she has um, um migraines.\n[Doctor] OK. And I think it's , certainly worth looking into that, so I can give you a , prescription for that today. Um, with regards to um, the next few days. It may be worth keeping a headache diary so we can try and work out what's, you know, if there's any triggers which could be causing your headaches to become worse.\n[Patient] Mm-hmm.\n[Doctor] And, and, you know I'd like you to come back and see me, in about uh, a week's time, week to two weeks' time. If you are having , more frequent episodes of these type of headaches. We can think about giving you medications as, prophylactic. Which basically means, medications to stop you from having these headaches on a regular basis. But we can have that discussion next time.\n[Patient] Mm, OK.\n[Doctor] OK. In the meantime if your headaches aren't getting any better, or they're getting worse. Um, you know, I want you to give me a call, or come back and see me sooner. OK?\n[Patient] OK. Yeah.\n[Doctor] So, if you're having any problems with your vision, or weakness in your arms and legs, or you're just not feeling very well. Just give me a call, and come back and see me.\n[Patient] OK.\n[Doctor] All right?\n[Patient] Great.\n[Doctor] Great. Well, have a good day.\n[Patient] Thank you. You too. Bye!\n[Doctor] Bye.",
"turns": [
{
"start": 0.0,
"end": 4.6111,
"text": "There's no . , hello?",
"speaker": "Doctor"
},
{
"start": 2.71698,
"end": 6.81131,
"text": ". Hi there.",
"speaker": "Patient"
},
{
"start": 6.31944,
"end": 14.0603,
"text": "Hello there. Um, thanks for, thanks for, being here. Um, before I go any further, can I uh, confirm your name and your age please?",
"speaker": "Doctor"
},
{
"start": 14.4528,
"end": 21.22636,
"text": "Yes, it's um Adriana Katherine . And I'm twenty six year old.",
"speaker": "Patient"
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"text": "",
"speaker": "Doctor"
},
{
"start": 20.22219,
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"text": "OK, Adriana, and how can I help you this afternoon?",
"speaker": "Doctor"
},
{
"start": 21.22636,
"end": 31.92445,
"text": "Well, I have this like really crazy headache that's been going on for a few days. And it really annoys me.",
"speaker": "Patient"
},
{
"start": 30.76281,
"end": 35.83328,
"text": "Ohh dear, OK. , when, when did it exactly start, this headache?",
"speaker": "Doctor"
},
{
"start": 35.49048,
"end": 39.11311,
"text": "Eh, around three days ago, maybe.",
"speaker": "Patient"
},
{
"start": 38.66661,
"end": 42.15272,
"text": "Three days ago, OK. And whereabout in your head, is this pain?",
"speaker": "Doctor"
},
{
"start": 42.72985,
"end": 54.04679,
"text": "Um, it's basically like, it kind of feels all over my head, but like mainly, um, around my right eye. Um",
"speaker": "Patient"
},
{
"start": 52.5277,
"end": 58.19436,
"text": ", OK. Um, and is the, headache there all the time, or does it come and go?",
"speaker": "Doctor"
},
{
"start": 58.91356,
"end": 69.28047,
"text": "Um it's, it kind of comes and goes. Um but, I mean it is there all the time, but like sometimes it's stronger.",
"speaker": "Patient"
},
{
"start": 68.69434,
"end": 77.68044,
"text": "OK, so it comes and, fine, OK. And if I was to ask you on a scale of one to ten, um, ten being the worst type of pain you ever had. How would you rate this headache?",
"speaker": "Doctor"
},
{
"start": 78.74737,
"end": 81.49741,
"text": "Ohh it's probably a eight.",
"speaker": "Patient"
},
{
"start": 80.94432,
"end": 89.55542,
"text": "Eight. And if I was to ask you describe the headache to me, um, in terms of the nature of the pain. Is it sharp? Is it dull? Is it crampy? Is it throbbing?",
"speaker": "Doctor"
},
{
"start": 90.98097,
"end": 104.44797,
"text": "Um, it's kind of, it's dull but sometimes it gets a bit sharper. So basically it like, it developed gradually, I guess. It's like the first day it just started when I was at work.",
"speaker": "Patient"
},
{
"start": 104.13873,
"end": 104.59706,
"text": "Mm-hmm.",
"speaker": "Doctor"
},
{
"start": 104.44797,
"end": 118.10071,
"text": "And by the end of the day it was like pretty, pretty, like it was a lot, basically. And then I was thinking OK, maybe I'll just go to sleep. And when I woke up the next morning like, it was even, even worse basically. So",
"speaker": "Patient"
},
{
"start": 112.81927,
"end": 113.4165,
"text": "Mm-hmm.",
"speaker": "Doctor"
},
{
"start": 117.32798,
"end": 120.19427,
"text": "So, you think the headache is getting worse over the last three days?",
"speaker": "Doctor"
},
{
"start": 120.47967,
"end": 121.47967,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 121.56719,
"end": 124.3543,
"text": "OK. Have you tried anything which has made the headache better?",
"speaker": "Doctor"
},
{
"start": 125.13232,
"end": 135.90082,
"text": "Um so I tried uh Ibuprofen. Um so I took, like a few. Um for the last two days, basically.",
"speaker": "Patient"
},
{
"start": 135.79147,
"end": 136.36091,
"text": "Did that help?",
"speaker": "Doctor"
},
{
"start": 135.90082,
"end": 141.98508,
"text": "But it doesn't really help, no. In in the past it did help me, which is why I decided to try it. But",
"speaker": "Patient"
},
{
"start": 141.77757,
"end": 145.37479,
"text": "OK, all right. And except for the headaches, any other symptoms at all?",
"speaker": "Doctor"
},
{
"start": 146.04826,
"end": 148.58512,
"text": "Um",
"speaker": "Patient"
},
{
"start": 146.70812,
"end": 150.95811,
"text": "So, example any, problems your eyesight or your vision?",
"speaker": "Doctor"
},
{
"start": 152.03777,
"end": 163.89049,
"text": "Not really, but just when it started, I I got this like weird shooting lights. And like now like light is quite annoying, my eyes.",
"speaker": "Patient"
},
{
"start": 164.0692,
"end": 167.48587,
"text": "So when you say annoying, does it hurt to look, uh, look at bright lights?",
"speaker": "Doctor"
},
{
"start": 167.07998,
"end": 170.61685,
"text": "Yeah, yeah. It hurts. So",
"speaker": "Patient"
},
{
"start": 169.9442,
"end": 174.54141,
"text": ", OK. And um, have you had any loss of vision or blurry vision?",
"speaker": "Doctor"
},
{
"start": 175.9432,
"end": 183.49062,
"text": "Not loss of vision, I wouldn't say. It's just like some lights from, shooting lights .",
"speaker": "Patient"
},
{
"start": 180.95807,
"end": 185.63862,
"text": "Mmm, , OK. Any nausea or any vomiting?",
"speaker": "Doctor"
},
{
"start": 186.51169,
"end": 192.78542,
"text": "Um, well I'm like basically, I I'm sick with the headache. But I, no vomiting.",
"speaker": "Patient"
},
{
"start": 193.24972,
"end": 200.37471,
"text": "When you say sick, you mean you feel sick? OK. Yeah, no vomiting, OK. Any neck pain or neck stiffness?",
"speaker": "Doctor"
},
{
"start": 195.21701,
"end": 196.21701,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 201.12231,
"end": 202.37494,
"text": "No.",
"speaker": "Patient"
},
{
"start": 203.06915,
"end": 207.94414,
"text": "OK. And any difficulty with speaking or, um, speech?",
"speaker": "Doctor"
},
{
"start": 207.13287,
"end": 209.64867,
"text": "No.",
"speaker": "Patient"
},
{
"start": 209.52747,
"end": 212.70802,
"text": "Any difficulty , with weakness in your arms and legs?",
"speaker": "Doctor"
},
{
"start": 214.11186,
"end": 219.88032,
"text": "No, it's hard to focus though. So, I I had to take a couple of days off work, actually.",
"speaker": "Patient"
},
{
"start": 219.93023,
"end": 229.208,
"text": "Ohh really? OK. OK, yeah probably, well I'll, I'll ask you a bit more about your work later on. Um, any recent head injuries at all?",
"speaker": "Doctor"
},
{
"start": 229.78566,
"end": 231.75408,
"text": "Uh, no.",
"speaker": "Patient"
},
{
"start": 232.20799,
"end": 236.88854,
"text": "OK. And have you had anything like this before in the past?",
"speaker": "Doctor"
},
{
"start": 236.15411,
"end": 238.97518,
"text": "Yeah I mean, headaches, you mean.",
"speaker": "Patient"
},
{
"start": 238.62465,
"end": 241.58298,
"text": "Or, uh, or similar, similar to, similar to this kind of headache, ?",
"speaker": "Doctor"
},
{
"start": 241.93309,
"end": 253.01739,
"text": "Yeah. I mean I had. But, usually after I I take uh Ibuprofen it kind of goes away. So, but this time it's just not. .",
"speaker": "Patient"
},
{
"start": 250.62463,
"end": 255.91629,
"text": " not, OK. All right. Um, any temperatures, or fevers?",
"speaker": "Doctor"
},
{
"start": 256.35425,
"end": 257.52267,
"text": "No.",
"speaker": "Patient"
},
{
"start": 257.97185,
"end": 260.01351,
"text": "Any rashes at all, on your skin?",
"speaker": "Doctor"
},
{
"start": 260.57532,
"end": 263.50165,
"text": "Mm, no not that I've noticed.",
"speaker": "Patient"
},
{
"start": 262.94406,
"end": 266.99961,
"text": "OK. And just moving forwards. Are you otherwise fit and well, Adriana?",
"speaker": "Doctor"
},
{
"start": 267.68063,
"end": 269.27011,
"text": "Am I what, sorry?",
"speaker": "Patient"
},
{
"start": 268.80517,
"end": 271.18016,
"text": "You fit and well? , do you have any other medical history?",
"speaker": "Doctor"
},
{
"start": 270.40695,
"end": 273.6596,
"text": "Yeah, I think so. It's just the headache.",
"speaker": "Patient"
},
{
"start": 273.52738,
"end": 275.38849,
"text": "Any history of migraines at all?",
"speaker": "Doctor"
},
{
"start": 276.38593,
"end": 282.60703,
"text": "Not myself, I've never had a migraine. But my sister and my mom have them quite frequently.",
"speaker": "Patient"
},
{
"start": 282.81904,
"end": 290.52736,
"text": "OK. Um, fine. I'll ask you a bit more about that in just a second. Before I go any further, can I ask, do you take any regular medication?",
"speaker": "Doctor"
},
{
"start": 291.97552,
"end": 297.12292,
"text": "Uh, no no.",
"speaker": "Patient"
},
{
"start": 294.27735,
"end": 295.20791,
"text": "Are you on the pill?",
"speaker": "Doctor"
},
{
"start": 297.01346,
"end": 299.41624,
"text": "OK. Do you have any allergies to any medications?",
"speaker": "Doctor"
},
{
"start": 299.8703,
"end": 302.23874,
"text": "Mm not that I know of.",
"speaker": "Patient"
},
{
"start": 302.31901,
"end": 305.29123,
"text": "OK. So you mentioned your mother and sister both have migraines.",
"speaker": "Doctor"
},
{
"start": 306.07034,
"end": 307.07034,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 307.18012,
"end": 312.79122,
"text": "Are they, is that normally well-controlled or are they um, having difficulty, controlling their symptoms?",
"speaker": "Doctor"
},
{
"start": 312.30195,
"end": 326.51259,
"text": "Um so my sister's, like better. Like it's kind of, it's very rare. But my mom's is like quite bad, um usually when there's like a season changing and stuff like that. It's, yeah.",
"speaker": "Patient"
},
{
"start": 326.0412,
"end": 327.1662,
"text": "Mm-hmm, OK.",
"speaker": "Doctor"
},
{
"start": 326.51259,
"end": 329.09155,
"text": "Takes her out for a few days, basically.",
"speaker": "Patient"
},
{
"start": 329.03394,
"end": 338.81896,
"text": "Ohh right, OK, fine. Um, socially, tell me a bit more about your life, outside of, um, outside of, work. So , who lives at home with you?",
"speaker": "Doctor"
},
{
"start": 339.56531,
"end": 344.5864,
"text": "Uh I live with housemates. So, three of them. So we're four .",
"speaker": "Patient"
},
{
"start": 342.70785,
"end": 347.95784,
"text": "OK. Excellent. And are you working at the moment? You mentioned this , impacting on your work.",
"speaker": "Doctor"
},
{
"start": 348.58643,
"end": 360.87073,
"text": "Yeah so I work, well I work in IT. So I work with computers a lot. So it kind of is difficult to focus. Um I had to like reduce the uh, brightness of my screen.",
"speaker": "Patient"
},
{
"start": 360.52726,
"end": 363.18004,
"text": "Mmm. OK. Do you wear glasses?",
"speaker": "Doctor"
},
{
"start": 363.44969,
"end": 364.81812,
"text": "Yes, I do.",
"speaker": "Patient"
},
{
"start": 364.69393,
"end": 367.77726,
"text": "Have you had any, uh, have you had any recent eye check, done? Eye test?",
"speaker": "Doctor"
},
{
"start": 368.61814,
"end": 375.74451,
"text": "No, uh I've been wearing them since I was five , five year old. So, it's quite a long time.",
"speaker": "Patient"
},
{
"start": 373.69391,
"end": 386.79111,
"text": "OK, all right. Something for you to bear in mind if you feel that you are, your eyes are straining. Um I would always recommend having a repeat eye test done. Um, have you been feeling more stressed or anxious at work recently?",
"speaker": "Doctor"
},
{
"start": 381.77613,
"end": 383.03929,
"text": "",
"speaker": "Patient"
},
{
"start": 388.11301,
"end": 394.83937,
"text": "Well, it's been a bit stressful, kicking off a new project. But um, yeah nothing out of the ordinary, really.",
"speaker": "Patient"
},
{
"start": 394.47166,
"end": 402.20776,
"text": "OK, all right. Great. Um, regarding smoking or alcohol. Do you drink or smoke at all?",
"speaker": "Doctor"
},
{
"start": 403.12364,
"end": 408.96579,
"text": "I socially smoke. And I drink only socially.",
"speaker": "Patient"
},
{
"start": 409.41608,
"end": 422.29567,
"text": "But only socially? OK. Right. Now um, Adriana, do you have any ideas as to what could be causing your symptoms? Have you, have you read anything online, or spoken to people?",
"speaker": "Doctor"
},
{
"start": 422.95537,
"end": 437.58706,
"text": "Um Not really. Um at first I thought it's stress, or maybe I didn't drink enough water. Because sometimes when I don't drink enough water, I I like get headaches. Um",
"speaker": "Patient"
},
{
"start": 436.10954,
"end": 436.59659,
"text": "Mm-hmm.",
"speaker": "Doctor"
},
{
"start": 437.58706,
"end": 446.4187,
"text": "But, I don't think that's it. And I'm like worried, it's, I don't want it to be a migraine. Because I know what it's like, from my mom and my sister.",
"speaker": "Patient"
},
{
"start": 440.33731,
"end": 440.66879,
"text": "",
"speaker": "Doctor"
},
{
"start": 446.36047,
"end": 446.98547,
"text": "Mmm.",
"speaker": "Doctor"
},
{
"start": 446.4187,
"end": 456.13456,
"text": "And it's really annoying. So I I really don't want to have that. And I know it's genetic. So I've researched that. Um but I don't know if that is the case. So, yeah.",
"speaker": "Patient"
},
{
"start": 455.72157,
"end": 459.76323,
"text": "OK. Is it anything in particular you were hoping I could do for you today?",
"speaker": "Doctor"
},
{
"start": 460.90302,
"end": 469.6715,
"text": "Yeah maybe just kinda, if you have any recommendations of that I can take something stronger. Because apparently, Ibuprofen doesn't help me. Uh",
"speaker": "Patient"
},
{
"start": 468.56877,
"end": 469.1521,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 469.6715,
"end": 476.14523,
"text": "Usually it gets resolved if I have headache in like, after like one or two days. But currently it, it didn't help me.",
"speaker": "Patient"
},
{
"start": 476.24931,
"end": 478.09653,
"text": "How many tablets did you take of Ibuprofen?",
"speaker": "Doctor"
},
{
"start": 479.21893,
"end": 482.54527,
"text": "Uh, three a day.",
"speaker": "Patient"
},
{
"start": 482.9993,
"end": 495.27706,
"text": "Three a day, OK. All right. Um, so uh, Adriana, so um, really what I think is going on here. I , uh, unfortunately I do think this could be, a headache very similar to a migraine.",
"speaker": "Doctor"
},
{
"start": 495.87169,
"end": 496.87169,
"text": "",
"speaker": "Patient"
},
{
"start": 496.05484,
"end": 529.36034,
"text": "Um, the reason I say that is because the history is very suggestive of it, given your mum and your sister also migraines. I think it's something for us to think about. Um, now I'm not saying it's gonna, keep happening, but, it may just be a one-off. But it's certainly worth treating it today stronger analgesia or painkillers. Um, now moving forward, we have some options which we can discuss. Uh, you tried the Ibuprofen. Now, my only worry is, I'm not sure whether you're taking, the correct dose. You can take up to two tablets, three times a day.",
"speaker": "Doctor"
},
{
"start": 530.12459,
"end": 531.35617,
"text": "Ohh right.",
"speaker": "Patient"
},
{
"start": 530.36034,
"end": 540.74921,
"text": "So, so , there's definitely room for, improvement there. Or, I can prescribe you something stronger, like Naproxen, which is another anti-inflammatory, which can be helpful.",
"speaker": "Doctor"
},
{
"start": 541.36677,
"end": 542.36677,
"text": "Mm-hmm.",
"speaker": "Patient"
},
{
"start": 541.49921,
"end": 548.84643,
"text": "Um, we can also add in other, painkillers like, Paracetamol, or Codeine. Which might be helpful as well.",
"speaker": "Doctor"
},
{
"start": 549.67209,
"end": 556.79846,
"text": "Mm, yeah. I think is what my mom takes for when she has um, um migraines.",
"speaker": "Patient"
},
{
"start": 556.20752,
"end": 572.97139,
"text": "OK. And I think it's , certainly worth looking into that, so I can give you a , prescription for that today. Um, with regards to um, the next few days. It may be worth keeping a headache diary so we can try and work out what's, you know, if there's any triggers which could be causing your headaches to become worse.",
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"text": "And, and, you know I'd like you to come back and see me, in about uh, a week's time, week to two weeks' time. If you are having , more frequent episodes of these type of headaches. We can think about giving you medications as, prophylactic. Which basically means, medications to stop you from having these headaches on a regular basis. But we can have that discussion next time.",
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"text": "Mm, OK.",
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"text": "OK. In the meantime if your headaches aren't getting any better, or they're getting worse. Um, you know, I want you to give me a call, or come back and see me sooner. OK?",
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"text": "So, if you're having any problems with your vision, or weakness in your arms and legs, or you're just not feeling very well. Just give me a call, and come back and see me.",
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"text": "OK.",
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"text": "All right?",
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"text": "Great.",
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"text": "Great. Well, have a good day.",
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"text": "Thank you. You too. Bye!",
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"doctor_utterances": "There's no . , hello? Hello there. Um, thanks for, thanks for, being here. Um, before I go any further, can I uh, confirm your name and your age please? OK, Adriana, and how can I help you this afternoon? Ohh dear, OK. , when, when did it exactly start, this headache? Three days ago, OK. And whereabout in your head, is this pain? , OK. Um, and is the, headache there all the time, or does it come and go? OK, so it comes and, fine, OK. And if I was to ask you on a scale of one to ten, um, ten being the worst type of pain you ever had. How would you rate this headache? Eight. And if I was to ask you describe the headache to me, um, in terms of the nature of the pain. Is it sharp? Is it dull? Is it crampy? Is it throbbing? Mm-hmm. Mm-hmm. So, you think the headache is getting worse over the last three days? OK. Have you tried anything which has made the headache better? Did that help? OK, all right. And except for the headaches, any other symptoms at all? So, example any, problems your eyesight or your vision? So when you say annoying, does it hurt to look, uh, look at bright lights? , OK. And um, have you had any loss of vision or blurry vision? Mmm, , OK. Any nausea or any vomiting? When you say sick, you mean you feel sick? OK. Yeah, no vomiting, OK. Any neck pain or neck stiffness? OK. And any difficulty with speaking or, um, speech? Any difficulty , with weakness in your arms and legs? Ohh really? OK. OK, yeah probably, well I'll, I'll ask you a bit more about your work later on. Um, any recent head injuries at all? OK. And have you had anything like this before in the past? Or, uh, or similar, similar to, similar to this kind of headache, ? not, OK. All right. Um, any temperatures, or fevers? Any rashes at all, on your skin? OK. And just moving forwards. Are you otherwise fit and well, Adriana? You fit and well? , do you have any other medical history? Any history of migraines at all? OK. Um, fine. I'll ask you a bit more about that in just a second. Before I go any further, can I ask, do you take any regular medication? Are you on the pill? OK. Do you have any allergies to any medications? OK. So you mentioned your mother and sister both have migraines. Are they, is that normally well-controlled or are they um, having difficulty, controlling their symptoms? Mm-hmm, OK. Ohh right, OK, fine. Um, socially, tell me a bit more about your life, outside of, um, outside of, work. So , who lives at home with you? OK. Excellent. And are you working at the moment? You mentioned this , impacting on your work. Mmm. OK. Do you wear glasses? Have you had any, uh, have you had any recent eye check, done? Eye test? OK, all right. Something for you to bear in mind if you feel that you are, your eyes are straining. Um I would always recommend having a repeat eye test done. Um, have you been feeling more stressed or anxious at work recently? OK, all right. Great. Um, regarding smoking or alcohol. Do you drink or smoke at all? But only socially? OK. Right. Now um, Adriana, do you have any ideas as to what could be causing your symptoms? Have you, have you read anything online, or spoken to people? Mm-hmm. Mmm. OK. Is it anything in particular you were hoping I could do for you today? OK. How many tablets did you take of Ibuprofen? Three a day, OK. All right. Um, so uh, Adriana, so um, really what I think is going on here. I , uh, unfortunately I do think this could be, a headache very similar to a migraine. Um, the reason I say that is because the history is very suggestive of it, given your mum and your sister also migraines. I think it's something for us to think about. Um, now I'm not saying it's gonna, keep happening, but, it may just be a one-off. But it's certainly worth treating it today stronger analgesia or painkillers. Um, now moving forward, we have some options which we can discuss. Uh, you tried the Ibuprofen. Now, my only worry is, I'm not sure whether you're taking, the correct dose. You can take up to two tablets, three times a day. So, so , there's definitely room for, improvement there. Or, I can prescribe you something stronger, like Naproxen, which is another anti-inflammatory, which can be helpful. Um, we can also add in other, painkillers like, Paracetamol, or Codeine. Which might be helpful as well. OK. And I think it's , certainly worth looking into that, so I can give you a , prescription for that today. Um, with regards to um, the next few days. It may be worth keeping a headache diary so we can try and work out what's, you know, if there's any triggers which could be causing your headaches to become worse. And, and, you know I'd like you to come back and see me, in about uh, a week's time, week to two weeks' time. If you are having , more frequent episodes of these type of headaches. We can think about giving you medications as, prophylactic. Which basically means, medications to stop you from having these headaches on a regular basis. But we can have that discussion next time. OK. In the meantime if your headaches aren't getting any better, or they're getting worse. Um, you know, I want you to give me a call, or come back and see me sooner. OK? So, if you're having any problems with your vision, or weakness in your arms and legs, or you're just not feeling very well. Just give me a call, and come back and see me. All right? Great. Well, have a good day. Bye.",
"patient_utterances": ". Hi there. Yes, it's um Adriana Katherine . And I'm twenty six year old. Well, I have this like really crazy headache that's been going on for a few days. And it really annoys me. Eh, around three days ago, maybe. Um, it's basically like, it kind of feels all over my head, but like mainly, um, around my right eye. Um Um it's, it kind of comes and goes. Um but, I mean it is there all the time, but like sometimes it's stronger. Ohh it's probably a eight. Um, it's kind of, it's dull but sometimes it gets a bit sharper. So basically it like, it developed gradually, I guess. It's like the first day it just started when I was at work. And by the end of the day it was like pretty, pretty, like it was a lot, basically. And then I was thinking OK, maybe I'll just go to sleep. And when I woke up the next morning like, it was even, even worse basically. So Yeah. Um so I tried uh Ibuprofen. Um so I took, like a few. Um for the last two days, basically. But it doesn't really help, no. In in the past it did help me, which is why I decided to try it. But Um Not really, but just when it started, I I got this like weird shooting lights. And like now like light is quite annoying, my eyes. Yeah, yeah. It hurts. So Not loss of vision, I wouldn't say. It's just like some lights from, shooting lights . Um, well I'm like basically, I I'm sick with the headache. But I, no vomiting. Yeah. No. No. No, it's hard to focus though. So, I I had to take a couple of days off work, actually. Uh, no. Yeah I mean, headaches, you mean. Yeah. I mean I had. But, usually after I I take uh Ibuprofen it kind of goes away. So, but this time it's just not. . No. Mm, no not that I've noticed. Am I what, sorry? Yeah, I think so. It's just the headache. Not myself, I've never had a migraine. But my sister and my mom have them quite frequently. Uh, no no. Mm not that I know of. Yeah. Um so my sister's, like better. Like it's kind of, it's very rare. But my mom's is like quite bad, um usually when there's like a season changing and stuff like that. It's, yeah. Takes her out for a few days, basically. Uh I live with housemates. So, three of them. So we're four . Yeah so I work, well I work in IT. So I work with computers a lot. So it kind of is difficult to focus. Um I had to like reduce the uh, brightness of my screen. Yes, I do. No, uh I've been wearing them since I was five , five year old. So, it's quite a long time. Well, it's been a bit stressful, kicking off a new project. But um, yeah nothing out of the ordinary, really. I socially smoke. And I drink only socially. Um Not really. Um at first I thought it's stress, or maybe I didn't drink enough water. Because sometimes when I don't drink enough water, I I like get headaches. Um But, I don't think that's it. And I'm like worried, it's, I don't want it to be a migraine. Because I know what it's like, from my mom and my sister. And it's really annoying. So I I really don't want to have that. And I know it's genetic. So I've researched that. Um but I don't know if that is the case. So, yeah. Yeah maybe just kinda, if you have any recommendations of that I can take something stronger. Because apparently, Ibuprofen doesn't help me. Uh Usually it gets resolved if I have headache in like, after like one or two days. But currently it, it didn't help me. Uh, three a day. Ohh right. Mm-hmm. Mm, yeah. I think is what my mom takes for when she has um, um migraines. Mm-hmm. Mm, OK. OK. Yeah. OK. Great. Thank you. You too. Bye!",
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"dialogue": "[Patient] Hello?\n[Doctor] Hello? Hello. Um, before I go any further, can I confirm your name and your date of birth?\n[Patient] Uh, yeah. Uh my name is April, and I'm fifty.\n[Doctor] You're fifty, OK. April, how can I help you this afternoon?\n[Patient] Well I've just been having this like, cough, for quite a few days. And my nose is running. Um and it's just been super annoying, and it's not going away.\n[Doctor] , OK. When did it all start?\n[Patient] Uh I think it started like maybe, a bit less than a week ago. Like maybe, maybe five or six days ago.\n[Doctor] OK. And you mentioned a couple of things there. You mentioned a cough. You mentioned a bit of a runny nose. Is that right?\n[Patient] \n[Doctor] OK. Let's focus on your cough first. Can you tell me a bit more about your cough?\n[Patient] Uh, it's just so continuous. It's really, really frustrating. It's quite dry. And it's just all day, it like keeps me up at night as well, which is really annoying.\n[Doctor] OK. So it's a dry cough. So you're not bringing up any , you're not bringing up any mucky, ohh I can hear that, yeah. Um you're not bringing up any uh, mucky phlegm or anything like that. No, OK. So it keeps you up at night. Um you mentioned uh the cold symptoms as well, the runny nose. Do you have a do you have a sore throat at all?\n[Patient] I mean, apart from, I mean the coughing is giving me a sore throat. But it's not like, you know not more than, than that. You know just, just my throat is irritated from coughing. But it's not like, it's not that bad when I swallow or anything.\n[Doctor] \n[Doctor] Right. Do you have any uh, how are your ears? Do you ears feel blocked or?\n[Patient] No.They feel OK, actually. Yeah. . Nothing, nothing on the ears.\n[Doctor] No pain, no discharge coming from your ears. \n[Doctor] OK, alright. Um fine. In terms of your breathing, how is your , how's your chest? Is your breathing more labored?\n[Patient] Um, I don't think so. Like, I guess I get laboured when I'm coughing and I can't breathe. But I, not, yeah, not, I, I don't think so. Not really.\n[Doctor] Day to day when you walk around, uh you don't feel breathless do you?\n[Patient] I don't feel restless. No, I feel you know, generally tired.\n[Doctor] \n[Doctor] OK. OK.\n[Patient] So like, yeah, but not, not anything special with my chest.\n[Doctor] Any pain in your chest? \n[Patient] No not, not that either.\n[Doctor] OK. You mentioned feeling tired. Um have you felt feverish at all? Have you had a temperature?\n[Patient] Um I've been having like, like shivers, even when I'm in, when I'm in bed. You know like, when you, when you go to sleep and, and you feel like I I should be warm. But I'm still, still you know, shivering a little bit.\n[Doctor] \n[Doctor] OK.\n[Patient] But I haven't taken my temperature, so I'm not a hundred percent sure if I had a fever. But it feels like I probably did. 'Cause I was just, I was next to my boyfriend. And he was completely warm and totally fine. And I just like couldn't stop shivering. And kept adding more sweaters on, and I was still cold.\n[Doctor] \n[Doctor] OK. OK. OK. Alright. Um, fine. And in terms of any other symptoms, so have you had any nausea? Have you had any vomiting?\n[Patient] No. No, no nausea. No vomiting. Like, um yeah, nothing like that.\n[Doctor] OK.\n[Doctor] How's your appetite?\n[Patient] Um, I mean it's OK. I, at the beginning, like when I was starting to have the , the , the coughing and stuff. Um, I had a little bit of diarrhea. Um but, but it didn't, it didn't cut my appetite or anything. I just like, my stomach wasn't feeling great.\n[Doctor] \n[Doctor] \n[Doctor] OK. Has that got better now, the diarrhea?\n[Patient] Yeah, yeah. It got better. It was only like the first, like it started at the same time as the cough started. And then it stopped. So I thought everything would be fine. But then the cough just kept going.\n[Doctor] OK fine. Um, any problems with your waterworks at all? \n[Patient] With my what?\n[Doctor] Uh your your waterworks, your urine. \n[Patient] Ohh. Uh, no. No no, it's fine.\n[Doctor] you're passing urine OK. You're drinking plenty of fluids, and passing urine OK.\n[Patient] No. I, I drank loads of water, when I started having the diarrhea. Now that it stopped, I just went back to normal.\n[Doctor] OK, alright. Um in terms of any other thing, do you notice any, any find any skin rashes, or um problems with your muscles or joints?\n[Patient] Uh like my, you know when I had the, when I was telling you I had like the, I had chills, and I was really cold. My muscle was really hurting.\n[Doctor] Yeah. OK. \n[Patient] Sometimes I do pilates. But like, it's hurting me so much at the moment. Um so, to be honest, all I feel like doing is just lying in bed.\n[Doctor] Right.\n[Doctor] Right, OK. OK. I'm sorry. That must be very difficult for you. \n[Patient] Yeah, right. Especially like in my arms, my legs, like just everywhere basically.\n[Doctor] quite lethargic and weak, you mentioned. Um, OK. And um, April are you normally otherwise fit and well?\n[Patient] Yeah, pretty much.\n[Patient] Am I normally what?\n[Doctor] Uh fit and well. So do you have any other medical history?\n[Patient] Uh, well I have type two diabetes. And I have quite high blood pressure.\n[Doctor] OK.\n[Doctor] OK. And what do you take for your blood pressure? Any, or what what medications do you take on a regular basis, if you don't mind saying?\n[Patient] Um I take Metformin for the diabetes. And I take Lisinopril for the high blood pressure.\n[Doctor] Yep.\n[Doctor] Zinopril. OK, fine. Any allergies at all, to medications?\n[Patient] No. No allergies.\n[Doctor] No, OK. Regarding any family history, is there anything I should be aware of?\n[Patient] Uh my dad also has type two diabetes. But I think that's it.\n[Doctor] OK, alright. Who's looking after your diabetes? Is there anyone, is there a doctor in a hospital, who looks after your diabetes?\n[Patient] I just regularly go see a doctor. Um, that just checks up on it. Same with the high blood pressure. Like I, I have it under control. And since I've started taking this medication, I've just been like regularly checking that it, it's under control.\n[Doctor] \n[Doctor] Right, excellent. And in terms of your social situation, who lives at home with you?\n[Patient] Uh just, it's just me and my partner.\n[Doctor] lives OK, um fine. Is your partner well at the moment?\n[Patient] Yeah he has none of this. Like he's just going ahead like, like nothing. Like I was a bit worried that I would pass it to him but, not uh, diarrhea, nothing, fine.\n[Doctor] Right, OK. So he\n[Doctor] Go away, he's got away with it, at the moment. OK. And uh, are you working at the moment, April?\n[Patient] \n[Patient] Uh, yeah I am working. But the, the first day I skipped. because I was feeling just too shit. Um, but then, I just felt like had to go back, 'cause I had so much to do. So I've been going in. But it's not been fun.\n[Doctor] Yeah.\n[Doctor] \n[Doctor] No, I can imagine. What is it that you do for work?\n[Patient] Uh, I am a developer.\n[Doctor] Ohh, so you work in the IT field. OK. IT field. Right, OK. Uh\n[Patient] yeah. Work in IT. not too active a job. Uh, yeah.\n[Doctor] No. Has it been quite stressful recently?\n[Patient] Not more than usual. I don't think it's related to stress. Like I, I don't feel like I've had a particularly hard time at work that way. Um\n[Doctor] OK.\n[Doctor] The reason I ask is sometimes\n[Patient] I've been able to take a day off to try and recover. So yeah, I don't think it's related.\n[Doctor] Sure. reason I ask is because sometimes stress can really affect your immune system. Um but uh it's good to know you're you're you're not feeling stressed. Um, do you smoke at all, April?\n[Patient] I used to, but I've stopped for about six months now.\n[Doctor] OK. Um and what about alcohol?\n[Patient] I mean, yeah I, I don't think I drank that much. Like, I I don't really know how you count the units. So I guess like I don't drink more than like, like, let's say three evenings a week? And I rarely get like properly drunk, or anything.\n[Doctor] And what is it that you drink?\n[Patient] Wine, mostly.\n[Doctor] The wine. How much do you drink on those nights?\n[Patient] Uh, I'd say like maybe two or three glasses.\n[Doctor] OK. So um, yeah so you're probably just about under the limit of um, the recommended limit. Something think about, just in terms of your blood pressure and diabetes, maybe something that you can maybe cut down on if you can.\n[Patient] Yeah? I should cut down on it.\n[Doctor] really ideally, the the the right answer is to cut down completely. But so in practice I know that's not realistic. So maybe for the first few weeks, why don't you cut down to two glasses a week. And then, one week thereafter Um and if you are coping OK, then you can maybe try and cut down altogether.\n[Patient] OK.\n[Doctor] OK? Just something for you to think about. Um, right so uh just as we wrap up really, um April I think based on your story, I think uh essentially I think you're, you're going through a bit of a bit of a viral illness. Um, I don't think there's anything to worry about.\n[Patient] Yeah.\n[Doctor] You know you've had a bit of a cough, bit of a runny nose, feeling quite weak and lethargic. I'm hoping that, you know, you're probably over the worst of it now. It's been five days. I'm hoping you're maybe going to get better in the next couple of days. It normally lasts for about a week to ten days.\n[Patient] What, what should I do if it just keeps going on and on? Like if it's still going on in, in say four days?\n[Doctor] Yeah, absolutely. So, you know things you can do to help yourself in the meantime is to, you know get some nice, good rest. Drink plenty of fluids. Keep yourself well-hydrated. You can take regular Paracetamol. If you feel like you're still not getting any better in two to three days, it's probably worth coming back to see me again. We can check you over. And if you are still feeling feverish, um and your cough isn't getting any better, then we may look to give you some antibiotics for your chest. some of the uh uh common source of infection. Um\n[Patient] Do you think I should keep going to work? Or do you think I should just\n[Doctor] Yeah so I think you know , really I think it depends on you. it's um if you are coughing, then there is a theoretical, you know risk that you're maybe slightly infectious still. So I would say maybe take a day or two off work, if you can. Uh and get some good bed rest. Um and maybe think about work early next week.\n[Patient] OK. OK. Thank you.\n[Doctor] But um, if your cough isn't getting any better, or your breathing is getting worse, I want you to come back and see me sooner. OK?\n[Patient] OK. But otherwise, I don't need to worry.\n[Doctor] No no no , nothing to worry about otherwise.\n[Patient] OK. Alright. Thank you very much.\n[Doctor] OK. Well, have a good day. Appreciate it.\n[Patient] Thank you. Bye!",
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"text": "Well I've just been having this like, cough, for quite a few days. And my nose is running. Um and it's just been super annoying, and it's not going away.",
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"text": "OK. And you mentioned a couple of things there. You mentioned a cough. You mentioned a bit of a runny nose. Is that right?",
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"text": "OK. So it's a dry cough. So you're not bringing up any , you're not bringing up any mucky, ohh I can hear that, yeah. Um you're not bringing up any uh, mucky phlegm or anything like that. No, OK. So it keeps you up at night. Um you mentioned uh the cold symptoms as well, the runny nose. Do you have a do you have a sore throat at all?",
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"text": "No.They feel OK, actually. Yeah. . Nothing, nothing on the ears.",
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"text": "Um, I don't think so. Like, I guess I get laboured when I'm coughing and I can't breathe. But I, not, yeah, not, I, I don't think so. Not really.",
"speaker": "Patient"
},
{
"start": 118.99219,
"end": 122.95702,
"text": "Day to day when you walk around, uh you don't feel breathless do you?",
"speaker": "Doctor"
},
{
"start": 123.17448,
"end": 128.12641,
"text": "I don't feel restless. No, I feel you know, generally tired.",
"speaker": "Patient"
},
{
"start": 124.752,
"end": 125.75999,
"text": "",
"speaker": "Doctor"
},
{
"start": 128.27635,
"end": 129.45864,
"text": "OK. OK.",
"speaker": "Doctor"
},
{
"start": 129.07183,
"end": 132.71768,
"text": "So like, yeah, but not, not anything special with my chest.",
"speaker": "Patient"
},
{
"start": 132.57297,
"end": 134.13784,
"text": "Any pain in your chest? ",
"speaker": "Doctor"
},
{
"start": 134.98205,
"end": 136.6914,
"text": "No not, not that either.",
"speaker": "Patient"
},
{
"start": 136.6674,
"end": 142.44332,
"text": "OK. You mentioned feeling tired. Um have you felt feverish at all? Have you had a temperature?",
"speaker": "Doctor"
},
{
"start": 143.33144,
"end": 155.84299,
"text": "Um I've been having like, like shivers, even when I'm in, when I'm in bed. You know like, when you, when you go to sleep and, and you feel like I I should be warm. But I'm still, still you know, shivering a little bit.",
"speaker": "Patient"
},
{
"start": 151.24125,
"end": 151.86387,
"text": "",
"speaker": "Doctor"
},
{
"start": 155.78715,
"end": 156.47389,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 155.84299,
"end": 170.5639,
"text": "But I haven't taken my temperature, so I'm not a hundred percent sure if I had a fever. But it feels like I probably did. 'Cause I was just, I was next to my boyfriend. And he was completely warm and totally fine. And I just like couldn't stop shivering. And kept adding more sweaters on, and I was still cold.",
"speaker": "Patient"
},
{
"start": 166.26451,
"end": 168.54778,
"text": " ",
"speaker": "Doctor"
},
{
"start": 170.3741,
"end": 179.34457,
"text": "OK. OK. OK. Alright. Um, fine. And in terms of any other symptoms, so have you had any nausea? Have you had any vomiting?",
"speaker": "Doctor"
},
{
"start": 179.76976,
"end": 185.60477,
"text": "No. No, no nausea. No vomiting. Like, um yeah, nothing like that.",
"speaker": "Patient"
},
{
"start": 182.47782,
"end": 183.01999,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 185.51411,
"end": 186.71161,
"text": "How's your appetite?",
"speaker": "Doctor"
},
{
"start": 187.79677,
"end": 207.03987,
"text": "Um, I mean it's OK. I, at the beginning, like when I was starting to have the , the , the coughing and stuff. Um, I had a little bit of diarrhea. Um but, but it didn't, it didn't cut my appetite or anything. I just like, my stomach wasn't feeling great.",
"speaker": "Patient"
},
{
"start": 199.79699,
"end": 200.43554,
"text": "",
"speaker": "Doctor"
},
{
"start": 203.84662,
"end": 204.28035,
"text": "",
"speaker": "Doctor"
},
{
"start": 207.48977,
"end": 209.55589,
"text": "OK. Has that got better now, the diarrhea?",
"speaker": "Doctor"
},
{
"start": 209.62541,
"end": 219.09924,
"text": "Yeah, yeah. It got better. It was only like the first, like it started at the same time as the cough started. And then it stopped. So I thought everything would be fine. But then the cough just kept going.",
"speaker": "Patient"
},
{
"start": 217.0516,
"end": 225.01815,
"text": " OK fine. Um, any problems with your waterworks at all? ",
"speaker": "Doctor"
},
{
"start": 225.5742,
"end": 226.65914,
"text": "With my what?",
"speaker": "Patient"
},
{
"start": 226.52349,
"end": 228.78927,
"text": "Uh your your waterworks, your urine. ",
"speaker": "Doctor"
},
{
"start": 229.03116,
"end": 231.62629,
"text": "Ohh. Uh, no. No no, it's fine.",
"speaker": "Patient"
},
{
"start": 230.90836,
"end": 234.83763,
"text": " you're passing urine OK. You're drinking plenty of fluids, and passing urine OK.",
"speaker": "Doctor"
},
{
"start": 235.01388,
"end": 241.15332,
"text": "No. I, I drank loads of water, when I started having the diarrhea. Now that it stopped, I just went back to normal.",
"speaker": "Patient"
},
{
"start": 240.95142,
"end": 251.53097,
"text": "OK, alright. Um in terms of any other thing, do you notice any, any find any skin rashes, or um problems with your muscles or joints?",
"speaker": "Doctor"
},
{
"start": 251.76949,
"end": 259.32587,
"text": "Uh like my, you know when I had the, when I was telling you I had like the, I had chills, and I was really cold. My muscle was really hurting.",
"speaker": "Patient"
},
{
"start": 257.29242,
"end": 260.02303,
"text": "Yeah. OK. ",
"speaker": "Doctor"
},
{
"start": 259.32587,
"end": 268.20514,
"text": "Sometimes I do pilates. But like, it's hurting me so much at the moment. Um so, to be honest, all I feel like doing is just lying in bed.",
"speaker": "Patient"
},
{
"start": 263.77542,
"end": 264.63694,
"text": "Right.",
"speaker": "Doctor"
},
{
"start": 268.05246,
"end": 274.97045,
"text": "Right, OK. OK. I'm sorry. That must be very difficult for you. ",
"speaker": "Doctor"
},
{
"start": 272.25363,
"end": 278.49235,
"text": "Yeah, right. Especially like in my arms, my legs, like just everywhere basically.",
"speaker": "Patient"
},
{
"start": 278.24612,
"end": 287.06459,
"text": " quite lethargic and weak, you mentioned. Um, OK. And um, April are you normally otherwise fit and well?",
"speaker": "Doctor"
},
{
"start": 280.70468,
"end": 282.34465,
"text": "Yeah, pretty much.",
"speaker": "Patient"
},
{
"start": 287.93563,
"end": 289.36626,
"text": "Am I normally what?",
"speaker": "Patient"
},
{
"start": 288.90515,
"end": 291.83976,
"text": "Uh fit and well. So do you have any other medical history?",
"speaker": "Doctor"
},
{
"start": 292.00384,
"end": 297.49255,
"text": "Uh, well I have type two diabetes. And I have quite high blood pressure.",
"speaker": "Patient"
},
{
"start": 294.48464,
"end": 295.81174,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 297.66222,
"end": 305.14828,
"text": "OK. And what do you take for your blood pressure? Any, or what what medications do you take on a regular basis, if you don't mind saying?",
"speaker": "Doctor"
},
{
"start": 304.67267,
"end": 311.85638,
"text": "Um I take Metformin for the diabetes. And I take Lisinopril for the high blood pressure.",
"speaker": "Patient"
},
{
"start": 308.34456,
"end": 308.93492,
"text": "Yep.",
"speaker": "Doctor"
},
{
"start": 311.23242,
"end": 314.80323,
"text": "Zinopril. OK, fine. Any allergies at all, to medications?",
"speaker": "Doctor"
},
{
"start": 314.46944,
"end": 316.11479,
"text": "No. No allergies.",
"speaker": "Patient"
},
{
"start": 314.80323,
"end": 320.33531,
"text": " No, OK. Regarding any family history, is there anything I should be aware of?",
"speaker": "Doctor"
},
{
"start": 320.70875,
"end": 324.98152,
"text": "Uh my dad also has type two diabetes. But I think that's it.",
"speaker": "Patient"
},
{
"start": 324.58859,
"end": 331.84944,
"text": "OK, alright. Who's looking after your diabetes? Is there anyone, is there a doctor in a hospital, who looks after your diabetes?",
"speaker": "Doctor"
},
{
"start": 331.15983,
"end": 344.41482,
"text": " I just regularly go see a doctor. Um, that just checks up on it. Same with the high blood pressure. Like I, I have it under control. And since I've started taking this medication, I've just been like regularly checking that it, it's under control.",
"speaker": "Patient"
},
{
"start": 334.51301,
"end": 335.79339,
"text": "",
"speaker": "Doctor"
},
{
"start": 343.95235,
"end": 349.28086,
"text": "Right, excellent. And in terms of your social situation, who lives at home with you?",
"speaker": "Doctor"
},
{
"start": 349.60387,
"end": 351.65354,
"text": "Uh just, it's just me and my partner.",
"speaker": "Patient"
},
{
"start": 351.37298,
"end": 355.79358,
"text": "lives OK, um fine. Is your partner well at the moment?",
"speaker": "Doctor"
},
{
"start": 355.54712,
"end": 366.52604,
"text": "Yeah he has none of this. Like he's just going ahead like, like nothing. Like I was a bit worried that I would pass it to him but, not uh, diarrhea, nothing, fine.",
"speaker": "Patient"
},
{
"start": 362.32635,
"end": 364.34506,
"text": "Right, OK. So he",
"speaker": "Doctor"
},
{
"start": 366.34428,
"end": 371.75127,
"text": "Go away, he's got away with it, at the moment. OK. And uh, are you working at the moment, April?",
"speaker": "Doctor"
},
{
"start": 368.09304,
"end": 368.60473,
"text": "",
"speaker": "Patient"
},
{
"start": 372.43311,
"end": 386.89146,
"text": "Uh, yeah I am working. But the, the first day I skipped. because I was feeling just too shit. Um, but then, I just felt like had to go back, 'cause I had so much to do. So I've been going in. But it's not been fun.",
"speaker": "Patient"
},
{
"start": 378.36388,
"end": 379.36388,
"text": "Yeah.",
"speaker": "Doctor"
},
{
"start": 383.43248,
"end": 384.27256,
"text": "",
"speaker": "Doctor"
},
{
"start": 386.68026,
"end": 389.33087,
"text": "No, I can imagine. What is it that you do for work?",
"speaker": "Doctor"
},
{
"start": 390.32212,
"end": 393.29345,
"text": "Uh, I am a developer.",
"speaker": "Patient"
},
{
"start": 393.46681,
"end": 399.87809,
"text": "Ohh, so you work in the IT field. OK. IT field. Right, OK. Uh",
"speaker": "Doctor"
},
{
"start": 395.76416,
"end": 403.58724,
"text": " yeah. Work in IT. not too active a job. Uh, yeah.",
"speaker": "Patient"
},
{
"start": 402.13044,
"end": 405.00936,
"text": "No. Has it been quite stressful recently?",
"speaker": "Doctor"
},
{
"start": 406.09922,
"end": 414.27816,
"text": "Not more than usual. I don't think it's related to stress. Like I, I don't feel like I've had a particularly hard time at work that way. Um",
"speaker": "Patient"
},
{
"start": 411.98171,
"end": 412.65835,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 414.27317,
"end": 415.60155,
"text": "The reason I ask is sometimes",
"speaker": "Doctor"
},
{
"start": 414.27816,
"end": 419.31711,
"text": " I've been able to take a day off to try and recover. So yeah, I don't think it's related.",
"speaker": "Patient"
},
{
"start": 417.89908,
"end": 429.82474,
"text": "Sure. reason I ask is because sometimes stress can really affect your immune system. Um but uh it's good to know you're you're you're not feeling stressed. Um, do you smoke at all, April?",
"speaker": "Doctor"
},
{
"start": 430.15278,
"end": 433.92855,
"text": "I used to, but I've stopped for about six months now.",
"speaker": "Patient"
},
{
"start": 434.41979,
"end": 437.9074,
"text": "OK. Um and what about alcohol?",
"speaker": "Doctor"
},
{
"start": 438.97525,
"end": 452.23384,
"text": "I mean, yeah I, I don't think I drank that much. Like, I I don't really know how you count the units. So I guess like I don't drink more than like, like, let's say three evenings a week? And I rarely get like properly drunk, or anything.",
"speaker": "Patient"
},
{
"start": 452.26283,
"end": 453.9901,
"text": "And what is it that you drink?",
"speaker": "Doctor"
},
{
"start": 454.69377,
"end": 456.41508,
"text": "Wine, mostly.",
"speaker": "Patient"
},
{
"start": 456.11407,
"end": 458.8992,
"text": "The wine. How much do you drink on those nights?",
"speaker": "Doctor"
},
{
"start": 459.47372,
"end": 462.40378,
"text": "Uh, I'd say like maybe two or three glasses.",
"speaker": "Patient"
},
{
"start": 462.85789,
"end": 479.50257,
"text": "OK. So um, yeah so you're probably just about under the limit of um, the recommended limit. Something think about, just in terms of your blood pressure and diabetes, maybe something that you can maybe cut down on if you can.",
"speaker": "Doctor"
},
{
"start": 479.40582,
"end": 482.76472,
"text": "Yeah? I should cut down on it.",
"speaker": "Patient"
},
{
"start": 479.50257,
"end": 499.40346,
"text": " really ideally, the the the right answer is to cut down completely. But so in practice I know that's not realistic. So maybe for the first few weeks, why don't you cut down to two glasses a week. And then, one week thereafter Um and if you are coping OK, then you can maybe try and cut down altogether.",
"speaker": "Doctor"
},
{
"start": 500.7572,
"end": 501.4774,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 501.35388,
"end": 515.66798,
"text": "OK? Just something for you to think about. Um, right so uh just as we wrap up really, um April I think based on your story, I think uh essentially I think you're, you're going through a bit of a bit of a viral illness. Um, I don't think there's anything to worry about.",
"speaker": "Doctor"
},
{
"start": 503.39007,
"end": 503.85534,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 515.66798,
"end": 530.44489,
"text": "You know you've had a bit of a cough, bit of a runny nose, feeling quite weak and lethargic. I'm hoping that, you know, you're probably over the worst of it now. It's been five days. I'm hoping you're maybe going to get better in the next couple of days. It normally lasts for about a week to ten days.",
"speaker": "Doctor"
},
{
"start": 530.57291,
"end": 535.74246,
"text": "What, what should I do if it just keeps going on and on? Like if it's still going on in, in say four days?",
"speaker": "Patient"
},
{
"start": 535.23003,
"end": 563.65161,
"text": "Yeah, absolutely. So, you know things you can do to help yourself in the meantime is to, you know get some nice, good rest. Drink plenty of fluids. Keep yourself well-hydrated. You can take regular Paracetamol. If you feel like you're still not getting any better in two to three days, it's probably worth coming back to see me again. We can check you over. And if you are still feeling feverish, um and your cough isn't getting any better, then we may look to give you some antibiotics for your chest. some of the uh uh common source of infection. Um",
"speaker": "Doctor"
},
{
"start": 563.03781,
"end": 565.85077,
"text": "Do you think I should keep going to work? Or do you think I should just",
"speaker": "Patient"
},
{
"start": 565.64335,
"end": 585.18887,
"text": "Yeah so I think you know , really I think it depends on you. it's um if you are coughing, then there is a theoretical, you know risk that you're maybe slightly infectious still. So I would say maybe take a day or two off work, if you can. Uh and get some good bed rest. Um and maybe think about work early next week.",
"speaker": "Doctor"
},
{
"start": 586.10576,
"end": 588.63636,
"text": "OK. OK. Thank you.",
"speaker": "Patient"
},
{
"start": 587.6021,
"end": 593.75914,
"text": "But um, if your cough isn't getting any better, or your breathing is getting worse, I want you to come back and see me sooner. OK?",
"speaker": "Doctor"
},
{
"start": 593.83021,
"end": 595.97306,
"text": "OK. But otherwise, I don't need to worry.",
"speaker": "Patient"
},
{
"start": 595.78593,
"end": 597.91309,
"text": "No no no , nothing to worry about otherwise.",
"speaker": "Doctor"
},
{
"start": 598.25138,
"end": 600.35612,
"text": "OK. Alright. Thank you very much.",
"speaker": "Patient"
},
{
"start": 598.88402,
"end": 601.92445,
"text": "OK. Well, have a good day. Appreciate it.",
"speaker": "Doctor"
},
{
"start": 601.79629,
"end": 603.20641,
"text": "Thank you. Bye!",
"speaker": "Patient"
}
],
"doctor_utterances": "Hello? Hello. Um, before I go any further, can I confirm your name and your date of birth? You're fifty, OK. April, how can I help you this afternoon? , OK. When did it all start? OK. And you mentioned a couple of things there. You mentioned a cough. You mentioned a bit of a runny nose. Is that right? OK. Let's focus on your cough first. Can you tell me a bit more about your cough? OK. So it's a dry cough. So you're not bringing up any , you're not bringing up any mucky, ohh I can hear that, yeah. Um you're not bringing up any uh, mucky phlegm or anything like that. No, OK. So it keeps you up at night. Um you mentioned uh the cold symptoms as well, the runny nose. Do you have a do you have a sore throat at all? Right. Do you have any uh, how are your ears? Do you ears feel blocked or? No pain, no discharge coming from your ears. OK, alright. Um fine. In terms of your breathing, how is your , how's your chest? Is your breathing more labored? Day to day when you walk around, uh you don't feel breathless do you? OK. OK. Any pain in your chest? OK. You mentioned feeling tired. Um have you felt feverish at all? Have you had a temperature? OK. OK. OK. OK. Alright. Um, fine. And in terms of any other symptoms, so have you had any nausea? Have you had any vomiting? OK. How's your appetite? OK. Has that got better now, the diarrhea? OK fine. Um, any problems with your waterworks at all? Uh your your waterworks, your urine. you're passing urine OK. You're drinking plenty of fluids, and passing urine OK. OK, alright. Um in terms of any other thing, do you notice any, any find any skin rashes, or um problems with your muscles or joints? Yeah. OK. Right. Right, OK. OK. I'm sorry. That must be very difficult for you. quite lethargic and weak, you mentioned. Um, OK. And um, April are you normally otherwise fit and well? Uh fit and well. So do you have any other medical history? OK. OK. And what do you take for your blood pressure? Any, or what what medications do you take on a regular basis, if you don't mind saying? Yep. Zinopril. OK, fine. Any allergies at all, to medications? No, OK. Regarding any family history, is there anything I should be aware of? OK, alright. Who's looking after your diabetes? Is there anyone, is there a doctor in a hospital, who looks after your diabetes? Right, excellent. And in terms of your social situation, who lives at home with you? lives OK, um fine. Is your partner well at the moment? Right, OK. So he Go away, he's got away with it, at the moment. OK. And uh, are you working at the moment, April? Yeah. No, I can imagine. What is it that you do for work? Ohh, so you work in the IT field. OK. IT field. Right, OK. Uh No. Has it been quite stressful recently? OK. The reason I ask is sometimes Sure. reason I ask is because sometimes stress can really affect your immune system. Um but uh it's good to know you're you're you're not feeling stressed. Um, do you smoke at all, April? OK. Um and what about alcohol? And what is it that you drink? The wine. How much do you drink on those nights? OK. So um, yeah so you're probably just about under the limit of um, the recommended limit. Something think about, just in terms of your blood pressure and diabetes, maybe something that you can maybe cut down on if you can. really ideally, the the the right answer is to cut down completely. But so in practice I know that's not realistic. So maybe for the first few weeks, why don't you cut down to two glasses a week. And then, one week thereafter Um and if you are coping OK, then you can maybe try and cut down altogether. OK? Just something for you to think about. Um, right so uh just as we wrap up really, um April I think based on your story, I think uh essentially I think you're, you're going through a bit of a bit of a viral illness. Um, I don't think there's anything to worry about. You know you've had a bit of a cough, bit of a runny nose, feeling quite weak and lethargic. I'm hoping that, you know, you're probably over the worst of it now. It's been five days. I'm hoping you're maybe going to get better in the next couple of days. It normally lasts for about a week to ten days. Yeah, absolutely. So, you know things you can do to help yourself in the meantime is to, you know get some nice, good rest. Drink plenty of fluids. Keep yourself well-hydrated. You can take regular Paracetamol. If you feel like you're still not getting any better in two to three days, it's probably worth coming back to see me again. We can check you over. And if you are still feeling feverish, um and your cough isn't getting any better, then we may look to give you some antibiotics for your chest. some of the uh uh common source of infection. Um Yeah so I think you know , really I think it depends on you. it's um if you are coughing, then there is a theoretical, you know risk that you're maybe slightly infectious still. So I would say maybe take a day or two off work, if you can. Uh and get some good bed rest. Um and maybe think about work early next week. But um, if your cough isn't getting any better, or your breathing is getting worse, I want you to come back and see me sooner. OK? No no no , nothing to worry about otherwise. OK. Well, have a good day. Appreciate it.",
"patient_utterances": "Hello? Uh, yeah. Uh my name is April, and I'm fifty. Well I've just been having this like, cough, for quite a few days. And my nose is running. Um and it's just been super annoying, and it's not going away. Uh I think it started like maybe, a bit less than a week ago. Like maybe, maybe five or six days ago. Uh, it's just so continuous. It's really, really frustrating. It's quite dry. And it's just all day, it like keeps me up at night as well, which is really annoying. I mean, apart from, I mean the coughing is giving me a sore throat. But it's not like, you know not more than, than that. You know just, just my throat is irritated from coughing. But it's not like, it's not that bad when I swallow or anything. No.They feel OK, actually. Yeah. . Nothing, nothing on the ears. Um, I don't think so. Like, I guess I get laboured when I'm coughing and I can't breathe. But I, not, yeah, not, I, I don't think so. Not really. I don't feel restless. No, I feel you know, generally tired. So like, yeah, but not, not anything special with my chest. No not, not that either. Um I've been having like, like shivers, even when I'm in, when I'm in bed. You know like, when you, when you go to sleep and, and you feel like I I should be warm. But I'm still, still you know, shivering a little bit. But I haven't taken my temperature, so I'm not a hundred percent sure if I had a fever. But it feels like I probably did. 'Cause I was just, I was next to my boyfriend. And he was completely warm and totally fine. And I just like couldn't stop shivering. And kept adding more sweaters on, and I was still cold. No. No, no nausea. No vomiting. Like, um yeah, nothing like that. Um, I mean it's OK. I, at the beginning, like when I was starting to have the , the , the coughing and stuff. Um, I had a little bit of diarrhea. Um but, but it didn't, it didn't cut my appetite or anything. I just like, my stomach wasn't feeling great. Yeah, yeah. It got better. It was only like the first, like it started at the same time as the cough started. And then it stopped. So I thought everything would be fine. But then the cough just kept going. With my what? Ohh. Uh, no. No no, it's fine. No. I, I drank loads of water, when I started having the diarrhea. Now that it stopped, I just went back to normal. Uh like my, you know when I had the, when I was telling you I had like the, I had chills, and I was really cold. My muscle was really hurting. Sometimes I do pilates. But like, it's hurting me so much at the moment. Um so, to be honest, all I feel like doing is just lying in bed. Yeah, right. Especially like in my arms, my legs, like just everywhere basically. Yeah, pretty much. Am I normally what? Uh, well I have type two diabetes. And I have quite high blood pressure. Um I take Metformin for the diabetes. And I take Lisinopril for the high blood pressure. No. No allergies. Uh my dad also has type two diabetes. But I think that's it. I just regularly go see a doctor. Um, that just checks up on it. Same with the high blood pressure. Like I, I have it under control. And since I've started taking this medication, I've just been like regularly checking that it, it's under control. Uh just, it's just me and my partner. Yeah he has none of this. Like he's just going ahead like, like nothing. Like I was a bit worried that I would pass it to him but, not uh, diarrhea, nothing, fine. Uh, yeah I am working. But the, the first day I skipped. because I was feeling just too shit. Um, but then, I just felt like had to go back, 'cause I had so much to do. So I've been going in. But it's not been fun. Uh, I am a developer. yeah. Work in IT. not too active a job. Uh, yeah. Not more than usual. I don't think it's related to stress. Like I, I don't feel like I've had a particularly hard time at work that way. Um I've been able to take a day off to try and recover. So yeah, I don't think it's related. I used to, but I've stopped for about six months now. I mean, yeah I, I don't think I drank that much. Like, I I don't really know how you count the units. So I guess like I don't drink more than like, like, let's say three evenings a week? And I rarely get like properly drunk, or anything. Wine, mostly. Uh, I'd say like maybe two or three glasses. Yeah? I should cut down on it. OK. Yeah. What, what should I do if it just keeps going on and on? Like if it's still going on in, in say four days? Do you think I should keep going to work? Or do you think I should just OK. OK. Thank you. OK. But otherwise, I don't need to worry. OK. Alright. Thank you very much. Thank you. Bye!",
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"reference_note": "{\"day\": 1, \"consultation\": 14, \"presenting_complaint\": \"I have a cough and cold\", \"note\": \"5/7 hx of cough and runny nose. Dry cough, keeps pt up at night. Runny nose, no ear pain, no sore throat. \\nNo SOB/chest pain\\nFeeling tired, weak and myalgia. \\nFeeling shivery, hot/cold, ?fever \\nNo nausea/vomiting \\nAppetite maintained. \\nInitial diarrhea - but now resolved \\nNil urinary symptoms\\nNo rashes \\n\\nPMH: Type 2 diabetes, HTN\\nDH: metformin, lisinopril \\nNKDA\\nFH: Father - type 2 diabetes \\nSH: lives with partner, works IT, denies stress. Ex-smoker - stopped 6/12 ago. Social EtOH <14 units/week\\n\\nImp: viral URTI \\n\\nPlan:\\n1.\\tSupportive mx - bed rest, fluids, regular paracetamol\\n2.\\tReview 5/7 if no better, or earlier if worsening sx (fever, SOB, chest pain)\\n\", \"highlights\": [\"cough\", \"runny nose\", \"myalgia\", \"Type 2 diabetes\", \"viral URTI\"]}",
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"dialogue": "[Doctor] Hello?\n[Patient] Hello?\n[Doctor] Hello. Can you hear me?\n[Patient] Yes.\n[Doctor] Great, excellent. Before I go any further, can I confirm you name and your, um, age please?\n[Patient] Uh yes. Um Laura Parkinson. And uh I'm forty five.\n[Doctor] Forty five. Alright Laura, well how can I help you this afternoon?\n[Patient] Uh yeah. So I have uh soreness in my fingers, my finger, like, the skin on my hands is kind of cracked.\n[Doctor] OK. When, when did this all start?\n[Patient] Um, a couple of months ago. I got it three, four months ago.\n[Doctor] OK so it's been that long, has it? OK. And so you mentioned your , is it the skin on your hand, mainly that's dry?\n[Patient] Yeah.\n[Patient] Yeah, I haven't noticed. I mean, I have dryness, like you know, in other parts, like my legs. But it's not, it's not very, it's not severe. It's just you know, I've always, you know, I don't hydrate very much. So\n[Doctor] Right. OK.\n[Patient] Yeah. Like it's very, it's very bad in my hands.\n[Doctor] OK. Can I ask why have you come to see me today? Uh is it because it's got worse recently, your symptoms?\n[Patient] Yeah I mean, it's gotten to a point where, where it hurts a lot. And I can't really do my job. So, I thought I should probably get it checked out.\n[Doctor] Yeah, that sounds like a very sensible plan. Um, which part of your hands are affected, mainly?\n[Patient] Uh the palm. I don't get, yeah.\n[Doctor] Um, OK alright. Um, have you any itchiness in your palms?\n[Patient] Yeah, it's itchy. Not all the time, but yeah, it does get itchy.\n[Doctor] OK. Any bleeding at all?\n[Patient] Um um I don't, I mean, no I don't think so.\n[Doctor] you scratch yourself, you scratching yourself often, and bleeding?\n[Patient] Um, yeah I guess when I scratched it, yes it has bled sometimes but, yeah. Otherwise, it hasn't bled on its own.\n[Doctor] OK. Um, fine. Uh OK. Sorry, I'm writing notes as we go along. Um, and you mentioned that skin is quite cracked as well. Is that right?\n[Patient] Yes, that's right.\n[Doctor] OK, alright. Um , I know it's a long time ago, but do you remember how it all started? what were you doing at the time when it all started? Is it anything you may have done, to bring your symptoms on?\n[Patient] Uh, I mean I am a, I do work as a housekeeper. Um\n[Doctor] \n[Patient] And to be honest, I'm not always very good about wearing gloves. So that could be related. Um, I switched jobs, uh four months ago. Uh\n[Doctor] OK. OK.\n[Doctor] OK.\n[Patient] I've been working for, as a housekeeper for, for a while now, but um, that's the only thing I can think of.\n[Doctor] Yeah, I think that might be quite important actually. I think there's definitely, maybe a correlation between the two. Um, fine. And so you mentioned something about having general dryness. Is that, you mentioned in your legs as well?\n[Patient] Yeah. Yeah but isn't, sorry.\n[Doctor] Is that, is that something you've, you've had for a while now?\n[Patient] Yeah. It's not really, it's not really major. Uh yeah it's just like literally grinding my legs.\n[Doctor] OK.\n[Patient] \n[Doctor] Right, OK. \n[Patient] trouble.\n[Doctor] OK. I'm just going to ask you some very brief yes or no questions, if that's OK. With your symptoms, have you, have you had any other symptoms, such as fever, or temperatures?\n[Patient] No.\n[Doctor] Any nausea, or any vomiting?\n[Patient] No.\n[Doctor] Any problem with your bowels?\n[Patient] No.\n[Doctor] Any problem with your urine, or waterworks? \n[Patient] No.\n[Doctor] Otherwise you feel well, do you? And yourself, your eating, drinking, your appetite is well-maintained?\n[Patient] Yeah. \n[Doctor] \n[Doctor] OK, alright. Fine. Um, in terms of your past medical history, do you have any other conditions at all?\n[Patient] I have diabetes.\n[Doctor] Do you know if that's type one or type two?\n[Patient] Type two.\n[Doctor] Diabetes, OK. Anything else?\n[Patient] Um no.\n[Doctor] Any skin problems?\n[Patient] No.\n[Doctor] Eczema, dermatitis, for exmaple?\n[Patient] Not that I know of. No, I haven't been diagnosed.\n[Doctor] No, OK. Which medications do you take?\n[Patient] \n[Doctor] Metformin, OK. Do you have any allergies, either to any medications or in general?\n[Patient] No.\n[Doctor] OK. Family history-wise, is there anything I should be aware of?\n[Patient] Diabetes and what?\n[Doctor] Diabetes as well. OK. Again, any skin problems?\n[Patient] Yeah.\n[Patient] Uh no, not that I know of.\n[Doctor] Any history of asthma, or bowel problems?\n[Patient] Uh, no.\n[Doctor] No. OK, alright. Um Fine. In terms of social history, you mentioned that you work as a housekeeper. Um are you, you're not always very good at wearing gloves.\n[Patient] Yeah.\n[Doctor] Um, you've recently changed jobs. Which which kind of places do you work in? Is it mainly residential, or is it commercial?\n[Patient] Yeah.\n[Patient] At a hotel. I have to do the whole thing like bedrooms, bathrooms, .\n[Doctor] Hotel, OK.\n[Doctor] OK. OK. Do you think there might be a relationship between the two? Between the, kind of the products you're using, and your symptoms?\n[Patient] Yeah, I usually use those for bathrooms. But, yeah bedrooms and corridors not always.\n[Doctor] OK. Have your symptoms stopped you from doing any work? Have you had to take time off work recently?\n[Patient] Uh, yeah like the past three days, I haven't been able to go to work.\n[Doctor] OK. Can I ask a couple questions? Do you smoke at all?\n[Patient] No.\n[Doctor] Do you drink much in the way of alcohol?\n[Patient] pints a week.\n[Doctor] Once a week?\n[Patient] Uh, a couple of pints a week.\n[Doctor] a week. OK so, very minimal, alcohol there. Um have you tried anything for your symptoms? Have you tried anything over the counter? Any creams?\n[Patient] Yeah. I tried uh E forty five.\n[Doctor] Any luck with that? \n[Patient] Yeah, no it didn't really do anything.\n[Doctor] No, OK. Alright. Um \n[Patient] I also tried an antihistamine, antihistamine. Uh but it didn't\n[Doctor] . OK, alright.\n[Doctor] Um, Mrs. Parkinson, so I think um, based on your story, I I think you might have something called dermatitis or contact dermatitis. Which is very common in, particularly people in your in your in your field, who are using cleaning products, not using gloves. And sometimes you get a bit of reaction between the chemicals and your skin. Um, so moving forward there's a couple of options. So firstly, what we try and do is, you know, avoid the triggers. In your case, I strongly recommend that you wear gloves when cleaning at all times.\n[Patient] Yeah.\n[Doctor] OK. And in terms of helping your dryness and the cracking of your skin, um we can try some steroid creams to help with the inflammation.\n[Patient] Yeah.\n[Doctor] \n[Patient] \n[Doctor] As well as some stronger emollients, um which you really need to kind of coat on, three four times a day, for the next couple of weeks, just to help with the moisturizing of your skin. \n[Patient] \n[Doctor] Um if it still hasn't got better in about a week, two weeks time, I really need you to come back and see me again. And we can maybe think about other things we can give to you. \n[Patient] OK.\n[Doctor] Is that all clear?\n[Patient] Uh yeah, that sounds good.\n[Doctor] Great. Do you have any questions for me?\n[Patient] Um, where do I get the medicine from?\n[Doctor] I'll I'll I'll do a prescription for you now, and send it over to your pharmacy.\n[Patient] OK great. Yeah, uh so you said a couple of weeks, it should get better, right?\n[Doctor] OK.\n[Doctor] I think I think minimum couple of weeks. Uh ten days to fourteen days. Um and if it still hasn't got better, or indeed if it's getting worse, like if it's spreading, or dryness is getting worse, come back and see me sooner.\n[Doctor] OK. Great. Thank you Laura. Thank you.\n[Patient] Alright. Thank you very much.\n[Doctor] . Bye bye now.\n[Patient] Bye.",
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"text": "Metformin, OK. Do you have any allergies, either to any medications or in general?",
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"text": "No.",
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"text": "OK. Family history-wise, is there anything I should be aware of?",
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"text": "Diabetes and what?",
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"text": "Diabetes as well. OK. Again, any skin problems?",
"speaker": "Doctor"
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"text": "Yeah.",
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"text": "Uh no, not that I know of.",
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"text": "Any history of asthma, or bowel problems?",
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"text": "Uh, no.",
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"text": "No. OK, alright. Um Fine. In terms of social history, you mentioned that you work as a housekeeper. Um are you, you're not always very good at wearing gloves.",
"speaker": "Doctor"
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"text": "Yeah.",
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"text": "Um, you've recently changed jobs. Which which kind of places do you work in? Is it mainly residential, or is it commercial?",
"speaker": "Doctor"
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"text": "Yeah.",
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"text": "Hotel, OK.",
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"text": "OK. OK. Do you think there might be a relationship between the two? Between the, kind of the products you're using, and your symptoms?",
"speaker": "Doctor"
},
{
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"text": "Yeah, I usually use those for bathrooms. But, yeah bedrooms and corridors not always.",
"speaker": "Patient"
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"text": "OK. Have your symptoms stopped you from doing any work? Have you had to take time off work recently?",
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"text": "Uh, yeah like the past three days, I haven't been able to go to work.",
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"text": "OK. Can I ask a couple questions? Do you smoke at all?",
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"text": "No.",
"speaker": "Patient"
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"text": "Do you drink much in the way of alcohol?",
"speaker": "Doctor"
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{
"start": 354.05278,
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"text": " pints a week.",
"speaker": "Patient"
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{
"start": 355.32566,
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"text": "Once a week?",
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"text": "Uh, a couple of pints a week.",
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"text": " a week. OK so, very minimal, alcohol there. Um have you tried anything for your symptoms? Have you tried anything over the counter? Any creams?",
"speaker": "Doctor"
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"text": "Yeah. I tried uh E forty five.",
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"text": "Any luck with that? ",
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"text": "Yeah, no it didn't really do anything.",
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"text": "No, OK. Alright. Um ",
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"text": "I also tried an antihistamine, antihistamine. Uh but it didn't",
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"text": ". OK, alright.",
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"text": "Um, Mrs. Parkinson, so I think um, based on your story, I I think you might have something called dermatitis or contact dermatitis. Which is very common in, particularly people in your in your in your field, who are using cleaning products, not using gloves. And sometimes you get a bit of reaction between the chemicals and your skin. Um, so moving forward there's a couple of options. So firstly, what we try and do is, you know, avoid the triggers. In your case, I strongly recommend that you wear gloves when cleaning at all times.",
"speaker": "Doctor"
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{
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"text": "Yeah.",
"speaker": "Patient"
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{
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"text": "OK. And in terms of helping your dryness and the cracking of your skin, um we can try some steroid creams to help with the inflammation.",
"speaker": "Doctor"
},
{
"start": 420.54819,
"end": 421.22424,
"text": "Yeah.",
"speaker": "Patient"
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{
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"speaker": "Doctor"
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{
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"text": "As well as some stronger emollients, um which you really need to kind of coat on, three four times a day, for the next couple of weeks, just to help with the moisturizing of your skin. ",
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"text": "Um if it still hasn't got better in about a week, two weeks time, I really need you to come back and see me again. And we can maybe think about other things we can give to you. ",
"speaker": "Doctor"
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{
"start": 451.78568,
"end": 452.39392,
"text": "OK.",
"speaker": "Patient"
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{
"start": 452.75518,
"end": 453.68037,
"text": "Is that all clear?",
"speaker": "Doctor"
},
{
"start": 453.97125,
"end": 455.60012,
"text": "Uh yeah, that sounds good.",
"speaker": "Patient"
},
{
"start": 455.58069,
"end": 457.00765,
"text": "Great. Do you have any questions for me?",
"speaker": "Doctor"
},
{
"start": 457.97128,
"end": 461.44554,
"text": "Um, where do I get the medicine from?",
"speaker": "Patient"
},
{
"start": 460.88335,
"end": 465.72756,
"text": " I'll I'll I'll do a prescription for you now, and send it over to your pharmacy.",
"speaker": "Doctor"
},
{
"start": 465.85797,
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"text": "OK great. Yeah, uh so you said a couple of weeks, it should get better, right?",
"speaker": "Patient"
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"text": "OK.",
"speaker": "Doctor"
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"text": "I think I think minimum couple of weeks. Uh ten days to fourteen days. Um and if it still hasn't got better, or indeed if it's getting worse, like if it's spreading, or dryness is getting worse, come back and see me sooner.",
"speaker": "Doctor"
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{
"start": 484.87047,
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"text": "OK. Great. Thank you Laura. Thank you.",
"speaker": "Doctor"
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{
"start": 487.94074,
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"text": "Alright. Thank you very much.",
"speaker": "Patient"
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{
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"text": ". Bye bye now.",
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"doctor_utterances": "Hello? Hello. Can you hear me? Great, excellent. Before I go any further, can I confirm you name and your, um, age please? Forty five. Alright Laura, well how can I help you this afternoon? OK. When, when did this all start? OK so it's been that long, has it? OK. And so you mentioned your , is it the skin on your hand, mainly that's dry? Right. OK. OK. Can I ask why have you come to see me today? Uh is it because it's got worse recently, your symptoms? Yeah, that sounds like a very sensible plan. Um, which part of your hands are affected, mainly? Um, OK alright. Um, have you any itchiness in your palms? OK. Any bleeding at all? you scratch yourself, you scratching yourself often, and bleeding? OK. Um, fine. Uh OK. Sorry, I'm writing notes as we go along. Um, and you mentioned that skin is quite cracked as well. Is that right? OK, alright. Um , I know it's a long time ago, but do you remember how it all started? what were you doing at the time when it all started? Is it anything you may have done, to bring your symptoms on? OK. OK. OK. Yeah, I think that might be quite important actually. I think there's definitely, maybe a correlation between the two. Um, fine. And so you mentioned something about having general dryness. Is that, you mentioned in your legs as well? Is that, is that something you've, you've had for a while now? OK. Right, OK. OK. I'm just going to ask you some very brief yes or no questions, if that's OK. With your symptoms, have you, have you had any other symptoms, such as fever, or temperatures? Any nausea, or any vomiting? Any problem with your bowels? Any problem with your urine, or waterworks? Otherwise you feel well, do you? And yourself, your eating, drinking, your appetite is well-maintained? OK, alright. Fine. Um, in terms of your past medical history, do you have any other conditions at all? Do you know if that's type one or type two? Diabetes, OK. Anything else? Any skin problems? Eczema, dermatitis, for exmaple? No, OK. Which medications do you take? Metformin, OK. Do you have any allergies, either to any medications or in general? OK. Family history-wise, is there anything I should be aware of? Diabetes as well. OK. Again, any skin problems? Any history of asthma, or bowel problems? No. OK, alright. Um Fine. In terms of social history, you mentioned that you work as a housekeeper. Um are you, you're not always very good at wearing gloves. Um, you've recently changed jobs. Which which kind of places do you work in? Is it mainly residential, or is it commercial? Hotel, OK. OK. OK. Do you think there might be a relationship between the two? Between the, kind of the products you're using, and your symptoms? OK. Have your symptoms stopped you from doing any work? Have you had to take time off work recently? OK. Can I ask a couple questions? Do you smoke at all? Do you drink much in the way of alcohol? Once a week? a week. OK so, very minimal, alcohol there. Um have you tried anything for your symptoms? Have you tried anything over the counter? Any creams? Any luck with that? No, OK. Alright. Um . OK, alright. Um, Mrs. Parkinson, so I think um, based on your story, I I think you might have something called dermatitis or contact dermatitis. Which is very common in, particularly people in your in your in your field, who are using cleaning products, not using gloves. And sometimes you get a bit of reaction between the chemicals and your skin. Um, so moving forward there's a couple of options. So firstly, what we try and do is, you know, avoid the triggers. In your case, I strongly recommend that you wear gloves when cleaning at all times. OK. And in terms of helping your dryness and the cracking of your skin, um we can try some steroid creams to help with the inflammation. As well as some stronger emollients, um which you really need to kind of coat on, three four times a day, for the next couple of weeks, just to help with the moisturizing of your skin. Um if it still hasn't got better in about a week, two weeks time, I really need you to come back and see me again. And we can maybe think about other things we can give to you. Is that all clear? Great. Do you have any questions for me? I'll I'll I'll do a prescription for you now, and send it over to your pharmacy. OK. I think I think minimum couple of weeks. Uh ten days to fourteen days. Um and if it still hasn't got better, or indeed if it's getting worse, like if it's spreading, or dryness is getting worse, come back and see me sooner. OK. Great. Thank you Laura. Thank you. . Bye bye now.",
"patient_utterances": "Hello? Yes. Uh yes. Um Laura Parkinson. And uh I'm forty five. Uh yeah. So I have uh soreness in my fingers, my finger, like, the skin on my hands is kind of cracked. Um, a couple of months ago. I got it three, four months ago. Yeah. Yeah, I haven't noticed. I mean, I have dryness, like you know, in other parts, like my legs. But it's not, it's not very, it's not severe. It's just you know, I've always, you know, I don't hydrate very much. So Yeah. Like it's very, it's very bad in my hands. Yeah I mean, it's gotten to a point where, where it hurts a lot. And I can't really do my job. So, I thought I should probably get it checked out. Uh the palm. I don't get, yeah. Yeah, it's itchy. Not all the time, but yeah, it does get itchy. Um um I don't, I mean, no I don't think so. Um, yeah I guess when I scratched it, yes it has bled sometimes but, yeah. Otherwise, it hasn't bled on its own. Yes, that's right. Uh, I mean I am a, I do work as a housekeeper. Um And to be honest, I'm not always very good about wearing gloves. So that could be related. Um, I switched jobs, uh four months ago. Uh I've been working for, as a housekeeper for, for a while now, but um, that's the only thing I can think of. Yeah. Yeah but isn't, sorry. Yeah. It's not really, it's not really major. Uh yeah it's just like literally grinding my legs. trouble. No. No. No. No. Yeah. I have diabetes. Type two. Um no. No. Not that I know of. No, I haven't been diagnosed. No. Diabetes and what? Yeah. Uh no, not that I know of. Uh, no. Yeah. Yeah. At a hotel. I have to do the whole thing like bedrooms, bathrooms, . Yeah, I usually use those for bathrooms. But, yeah bedrooms and corridors not always. Uh, yeah like the past three days, I haven't been able to go to work. No. pints a week. Uh, a couple of pints a week. Yeah. I tried uh E forty five. Yeah, no it didn't really do anything. I also tried an antihistamine, antihistamine. Uh but it didn't Yeah. Yeah. OK. Uh yeah, that sounds good. Um, where do I get the medicine from? OK great. Yeah, uh so you said a couple of weeks, it should get better, right? Alright. Thank you very much. Bye.",
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"reference_note": "{\"day\": 1, \"consultation\": 15, \"presenting_complaint\": \"I have sore, cracked skin on my hands\", \"note\": \"3-4/12 hx of sore and cracked skin on my hands - mainly palms. Occasionally itchy and bleeding on scratching. No pain \\nWorks as a cleaner and does not always wear gloves - possible trigger\\nNo fever\\nNo bowel/urinary sx\\nAppetite maintained \\n\\nPMH: Type 2 diabetes\\nDH: metformin \\nNKDA\\nFH: Type 2 diabetes, \\nSH: works as a housekeeper, recently changed jobs 4/12 ago, works in a hotel. \\nNil smoking\\nMinimal etOH\\n\\nHas tried E45 cream and antihistamines with minimal relief \\n\\nImp: contact dermatitis \\n\\nPlan:\\n1.\\tSteroid cream BD\\n2.\\tEmollients - regular use \\n3.\\tAvoid trigger, wear cleaning gloves\\n4.\\tReview in 10-14d INB, or earlier if worsening sx\\n\", \"highlights\": [\"sore and cracked skin\", \"itchy\", \"cleaner\", \"Type 2 diabetes\", \"contact dermatitis\"]}",
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"dialogue": "[Doctor] Hi, there. Good morning!\n[Patient] \n[Doctor] Uh, I'm Dr. Dean Mesa from Babylon.\n[Patient] \n[Doctor] Can you hear me OK?\n[Patient] Yep. Can you find\n[Doctor] Yeah, OK, great. Well, nice to see you this morning. Um, before we start your appointment, could I confirm your full name and date of birth please?\n[Patient] Uh yeah, uh Jack Smith, uh thirty first October nineteen ninety.\n[Doctor] That's perfect, thank you, John. Um, are you in a private place where you're OK to speak at the moment?\n[Patient] I am, yes\n[Doctor] OK, great. So, um, tell me what's been going on. You've been saying there's a problem with your hearing. Is that right?\n[Patient] Yeah, so I just feel I can't really hear as well as I used to, like my hearing is kind of deteriorating in some way.\n[Doctor] Right, OK. How long has this been going on for?\n[Patient] Uh about six weeks.\n[Doctor] Six weeks, OK. Um, and before that have you had any hearing problem at all?\n[Patient] Um I had something maybe, about a year ago, but it only lasted a couple of days, it wasn't anything as long as this.\n[Doctor] Right, OK, OK. And, um, in this six week period, have you had anything else happen? Have you had any other ear symptoms at all?\n[Patient] Um, I occasionally get like a ringing in my left ear, uh just on the one side and um there's actually been a few times when I felt kind of a bit sick or a bit dizzy as well.\n[Doctor] Right, OK. Uh, uh, um, just to clarify, the difficulty you've got in hearing, is that both ears or just the left ear?\n[Patient] Uh just the left ear, yeah.\n[Doctor] Alright, so your right ear is fine.\n[Patient] It seems be yeah.\n[Doctor] OK. So you've had ringing, difficulty hearing in your left ear, and feeling slightly sick.\n[Patient] Mh-mm.\n[Doctor] Um, that's been, on and off for the six weeks, or is it continuous there throughout that six weeks?\n[Patient] Yeah.\n[Patient] Uh it's kind of on and off. Like some things trigger it as well. So, for example, if I'm watching TV or listen to music or something that'll solve the ringing in the ear.\n[Doctor] Right, OK. Um, and, um, have you had any pain from the ear at all?\n[Patient] Uh no my left ear.\n[Doctor] OK. Any discharge coming out of the ear? No, OK. Um, have, have you been experiencing any fever?\n[Patient] \n[Patient] Uh, not specifically apart from the dizziness so much.\n[Doctor] Right, OK. And, um, has your ear been itchy at all?\n[Patient] \n[Doctor] OK. Now, do you use cotton ball buds to try and clean out wax from your ears?\n[Patient] Uh nah I'll do it.\n[Doctor] No, OK. Well, you're right, you should, you shouldn't be doing that. Doesn't clean up wax, it pushes it back in. Alright, um, the first thing that we need to do is we need to get someone to have a look inside your ear. 'K. I'm just exclude the simple things. Simple things might be wax. You know. Someone might have impacted wax, blocking the tube going into the eardrum, which can\n[Patient] OK.\n[Doctor] lead to muffled hearing. Um, if that's the case, that that's something that's easy fixable. But, um, so we need to exclude that first. and then after that, we can consider other potential possibilities. Um, and for that we need to have a look inside the ear drum. So, um, what I think we could do is, um, maybe if we book you in for a face-to-face appointment in one of our clinics. It's not an emergency. It can be done within the next four, five days or so, OK? And then, um, what I'll do, I'll send a message to our admin team. I'll ask them to slot you into the clinic, one of our clinics in that time frame. You can come in and one of the GPs will just have a quick look in the ear and figure out whether there's physical blockage or whether there's something else going on, OK? Um, can I just double check, the dizziness that you've been getting, um, how severe is it?\n[Patient] OK.\n[Patient] Yeah.\n[Patient] Uh nothing major it's just kind of uh it's, it's not the kind of dizziness you get with nausea, like uh not, not proper room spinning or anything like that but just, just a little bit kind of off balance.\n[Doctor] \n[Doctor] Right, right, OK. Have, have you had any chest pain with it?\n[Patient] \n[Patient] No.\n[Doctor] No. Any palpitations, heart beating fast?\n[Patient] \n[Doctor] OK, fine, alright. Um, so let's get your ear checked out. I think that will be the, the most sensible thing to do. And then after that, we can, we'll be a step closer to figuring out which way we It might be that there's a problem inside the drum or the balance system within the ear. But, we just need to exclude whether there's physical blockage first and trying to deal with that if that's the case, OK? Um, but\n[Patient] is that the sort of thing that can cause uh like this uh ringing I've got in my ear, 'cause it seems .\n[Doctor] The ringing that you got, that you've got, it's something called Tinnitus. OK? Um\n[Patient] Right.\n[Doctor] and Tinnitus is something actually that medicine doctors, we don't really understand it fully. We haven't\n[Patient] OK.\n[Doctor] Uh, people can't give you a specific cause for why some patients get Tinnitus and some patients don't. It can be triggered by a wide range of different things, and in fact I'm glad that you've mentioned that. What I might do, in the time between now and when you come for the appointment, I'm going to, uh, put paste the link for a leaflet about Tinnitus, um, in the notes for this appointment. I'd really appreciate it if you could start reading about it.\n[Patient] OK.\n[Patient] Sure.\n[Doctor] OK. And often that, that, uh, awareness of what it is and what the treatment options are, and there are limited options um that helps us in terms of conversation about what we do next, if your ear is clear, OK? So, um, I'm going to paste a link to that, um, and you can read about that and what we'll do is we'll see you in about four, five days time. It won't be with me, it'll be another GP but they'll have my notes and they'll know exactly what, what my question is, which is just to check your ears. Is that OK?\n[Patient] OK.\n[Patient] Yeah it sounds great.\n[Doctor] Alright, great. So, um, bear with me five minutes and then you can ring the support team, I'll leave the number in the notes for this appointment. Ring them, and then they'll slot you in, OK?\n[Patient] OK brilliant.\n[Doctor] Alright. If there's any problem, any issues between now and when the clinic appointment is, just book another appointment and you can speak to one of us over video, OK?\n[Patient] OK.\n[Doctor] Alright then. Take care. Nice to see you this morning. OK. Bye bye.\n[Patient] Thank you. See you later.",
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"text": "Right, OK. Uh, uh, um, just to clarify, the difficulty you've got in hearing, is that both ears or just the left ear?",
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"text": "Uh just the left ear, yeah.",
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"text": "Alright, so your right ear is fine.",
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"text": "It seems be yeah.",
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"text": "OK. So you've had ringing, difficulty hearing in your left ear, and feeling slightly sick.",
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"text": "Mh-mm.",
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"text": "Um, that's been, on and off for the six weeks, or is it continuous there throughout that six weeks?",
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"text": "Yeah.",
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"text": "Uh it's kind of on and off. Like some things trigger it as well. So, for example, if I'm watching TV or listen to music or something that'll solve the ringing in the ear.",
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"text": "Right, OK. Um, and, um, have you had any pain from the ear at all?",
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"text": "Uh, not specifically apart from the dizziness so much.",
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"text": "Right, OK. And, um, has your ear been itchy at all?",
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"text": "OK. Now, do you use cotton ball buds to try and clean out wax from your ears?",
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"text": "Uh nah I'll do it.",
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"text": "No, OK. Well, you're right, you should, you shouldn't be doing that. Doesn't clean up wax, it pushes it back in. Alright, um, the first thing that we need to do is we need to get someone to have a look inside your ear. 'K. I'm just exclude the simple things. Simple things might be wax. You know. Someone might have impacted wax, blocking the tube going into the eardrum, which can",
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"text": "lead to muffled hearing. Um, if that's the case, that that's something that's easy fixable. But, um, so we need to exclude that first. and then after that, we can consider other potential possibilities. Um, and for that we need to have a look inside the ear drum. So, um, what I think we could do is, um, maybe if we book you in for a face-to-face appointment in one of our clinics. It's not an emergency. It can be done within the next four, five days or so, OK? And then, um, what I'll do, I'll send a message to our admin team. I'll ask them to slot you into the clinic, one of our clinics in that time frame. You can come in and one of the GPs will just have a quick look in the ear and figure out whether there's physical blockage or whether there's something else going on, OK? Um, can I just double check, the dizziness that you've been getting, um, how severe is it?",
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"text": "OK.",
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"text": "Yeah.",
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"text": "Uh nothing major it's just kind of uh it's, it's not the kind of dizziness you get with nausea, like uh not, not proper room spinning or anything like that but just, just a little bit kind of off balance.",
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"text": "Right, right, OK. Have, have you had any chest pain with it?",
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"text": "No. Any palpitations, heart beating fast?",
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"text": "OK, fine, alright. Um, so let's get your ear checked out. I think that will be the, the most sensible thing to do. And then after that, we can, we'll be a step closer to figuring out which way we It might be that there's a problem inside the drum or the balance system within the ear. But, we just need to exclude whether there's physical blockage first and trying to deal with that if that's the case, OK? Um, but",
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"text": " is that the sort of thing that can cause uh like this uh ringing I've got in my ear, 'cause it seems .",
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"text": " The ringing that you got, that you've got, it's something called Tinnitus. OK? Um",
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"text": "Right.",
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"text": "and Tinnitus is something actually that medicine doctors, we don't really understand it fully. We haven't",
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"text": "OK.",
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"text": "Uh, people can't give you a specific cause for why some patients get Tinnitus and some patients don't. It can be triggered by a wide range of different things, and in fact I'm glad that you've mentioned that. What I might do, in the time between now and when you come for the appointment, I'm going to, uh, put paste the link for a leaflet about Tinnitus, um, in the notes for this appointment. I'd really appreciate it if you could start reading about it.",
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"text": "OK. And often that, that, uh, awareness of what it is and what the treatment options are, and there are limited options um that helps us in terms of conversation about what we do next, if your ear is clear, OK? So, um, I'm going to paste a link to that, um, and you can read about that and what we'll do is we'll see you in about four, five days time. It won't be with me, it'll be another GP but they'll have my notes and they'll know exactly what, what my question is, which is just to check your ears. Is that OK?",
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{
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"text": "OK.",
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{
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"text": "Yeah it sounds great.",
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"text": "Alright, great. So, um, bear with me five minutes and then you can ring the support team, I'll leave the number in the notes for this appointment. Ring them, and then they'll slot you in, OK?",
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"text": "OK brilliant.",
"speaker": "Patient"
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{
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"text": "Alright. If there's any problem, any issues between now and when the clinic appointment is, just book another appointment and you can speak to one of us over video, OK?",
"speaker": "Doctor"
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{
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"text": "OK.",
"speaker": "Patient"
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{
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"text": "Alright then. Take care. Nice to see you this morning. OK. Bye bye.",
"speaker": "Doctor"
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{
"start": 325.48358,
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"text": "Thank you. See you later.",
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],
"doctor_utterances": "Hi, there. Good morning! Uh, I'm Dr. Dean Mesa from Babylon. Can you hear me OK? Yeah, OK, great. Well, nice to see you this morning. Um, before we start your appointment, could I confirm your full name and date of birth please? That's perfect, thank you, John. Um, are you in a private place where you're OK to speak at the moment? OK, great. So, um, tell me what's been going on. You've been saying there's a problem with your hearing. Is that right? Right, OK. How long has this been going on for? Six weeks, OK. Um, and before that have you had any hearing problem at all? Right, OK, OK. And, um, in this six week period, have you had anything else happen? Have you had any other ear symptoms at all? Right, OK. Uh, uh, um, just to clarify, the difficulty you've got in hearing, is that both ears or just the left ear? Alright, so your right ear is fine. OK. So you've had ringing, difficulty hearing in your left ear, and feeling slightly sick. Um, that's been, on and off for the six weeks, or is it continuous there throughout that six weeks? Right, OK. Um, and, um, have you had any pain from the ear at all? OK. Any discharge coming out of the ear? No, OK. Um, have, have you been experiencing any fever? Right, OK. And, um, has your ear been itchy at all? OK. Now, do you use cotton ball buds to try and clean out wax from your ears? No, OK. Well, you're right, you should, you shouldn't be doing that. Doesn't clean up wax, it pushes it back in. Alright, um, the first thing that we need to do is we need to get someone to have a look inside your ear. 'K. I'm just exclude the simple things. Simple things might be wax. You know. Someone might have impacted wax, blocking the tube going into the eardrum, which can lead to muffled hearing. Um, if that's the case, that that's something that's easy fixable. But, um, so we need to exclude that first. and then after that, we can consider other potential possibilities. Um, and for that we need to have a look inside the ear drum. So, um, what I think we could do is, um, maybe if we book you in for a face-to-face appointment in one of our clinics. It's not an emergency. It can be done within the next four, five days or so, OK? And then, um, what I'll do, I'll send a message to our admin team. I'll ask them to slot you into the clinic, one of our clinics in that time frame. You can come in and one of the GPs will just have a quick look in the ear and figure out whether there's physical blockage or whether there's something else going on, OK? Um, can I just double check, the dizziness that you've been getting, um, how severe is it? Right, right, OK. Have, have you had any chest pain with it? No. Any palpitations, heart beating fast? OK, fine, alright. Um, so let's get your ear checked out. I think that will be the, the most sensible thing to do. And then after that, we can, we'll be a step closer to figuring out which way we It might be that there's a problem inside the drum or the balance system within the ear. But, we just need to exclude whether there's physical blockage first and trying to deal with that if that's the case, OK? Um, but The ringing that you got, that you've got, it's something called Tinnitus. OK? Um and Tinnitus is something actually that medicine doctors, we don't really understand it fully. We haven't Uh, people can't give you a specific cause for why some patients get Tinnitus and some patients don't. It can be triggered by a wide range of different things, and in fact I'm glad that you've mentioned that. What I might do, in the time between now and when you come for the appointment, I'm going to, uh, put paste the link for a leaflet about Tinnitus, um, in the notes for this appointment. I'd really appreciate it if you could start reading about it. OK. And often that, that, uh, awareness of what it is and what the treatment options are, and there are limited options um that helps us in terms of conversation about what we do next, if your ear is clear, OK? So, um, I'm going to paste a link to that, um, and you can read about that and what we'll do is we'll see you in about four, five days time. It won't be with me, it'll be another GP but they'll have my notes and they'll know exactly what, what my question is, which is just to check your ears. Is that OK? Alright, great. So, um, bear with me five minutes and then you can ring the support team, I'll leave the number in the notes for this appointment. Ring them, and then they'll slot you in, OK? Alright. If there's any problem, any issues between now and when the clinic appointment is, just book another appointment and you can speak to one of us over video, OK? Alright then. Take care. Nice to see you this morning. OK. Bye bye.",
"patient_utterances": " Yep. Can you find Uh yeah, uh Jack Smith, uh thirty first October nineteen ninety. I am, yes Yeah, so I just feel I can't really hear as well as I used to, like my hearing is kind of deteriorating in some way. Uh about six weeks. Um I had something maybe, about a year ago, but it only lasted a couple of days, it wasn't anything as long as this. Um, I occasionally get like a ringing in my left ear, uh just on the one side and um there's actually been a few times when I felt kind of a bit sick or a bit dizzy as well. Uh just the left ear, yeah. It seems be yeah. Mh-mm. Yeah. Uh it's kind of on and off. Like some things trigger it as well. So, for example, if I'm watching TV or listen to music or something that'll solve the ringing in the ear. Uh no my left ear. Uh, not specifically apart from the dizziness so much. Uh nah I'll do it. OK. OK. Yeah. Uh nothing major it's just kind of uh it's, it's not the kind of dizziness you get with nausea, like uh not, not proper room spinning or anything like that but just, just a little bit kind of off balance. No. is that the sort of thing that can cause uh like this uh ringing I've got in my ear, 'cause it seems . Right. OK. OK. Sure. OK. Yeah it sounds great. OK brilliant. OK. Thank you. See you later.",
"num_turns": 66,
"reference_note": "{\"day\": 2, \"consultation\": 1, \"presenting_complaint\": \"I don't hear as well as I used to\", \"note\": \"History: \\nHx of difficulty hearing left ear for 6 weeks with tinnitus and slight nausea/ dizziness. \\nOne previous similar episode in the past- resolved spontaneously.\\nNo discharge/ fever/ itchiness/ pain\\nDoesn't use cotton wool buds\\nNo Pmhx of note\\nEx: Looks well, not in pain.\\nImp: need to exclude impacted wax in ear canal first\\nPln: for face to face GP appointment in 5 days to examine ear\\nPt to read about tinnitus in the meantime via following link: www.patient.co.uk/tinnitus\\nIf any problems in interim to ring us back\\nPt happy with and understands plan\\n\", \"highlights\": [\"difficulty hearing\", \"tinnitus\", \"need to exclude impacted wax\", \"examine ear\"]}",
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"dialogue": "[Patient] Hello?\n[Doctor] Hi there. Good morning!\n[Patient] Hi. . Nice to meet you. Hello.\n[Doctor] Hello. I, I'm Doctor . Nice to see you. Hi. Um, so, before we start your appointment, could I confirm your full name and date of birth, if that's OK?\n[Patient] Uh, yeah. Uh, Mary Richards. Uh, and my, I'm forty years old. So.\n[Doctor] You're OK, fine. So, you're you're forty years old, you said, yeah?\n[Patient] \n[Doctor] Perfect, OK. Um, are you in a private place where you're OK to speak at the moment?\n[Patient] Yep.\n[Doctor] OK, great. Um, so how can I help you today?\n[Patient] Um, so, just been having some, um, problems with my hearing, I can't really hear very well, and my , noticed that my face has been feeling a bit numb recently.\n[Doctor] Right, OK. OK. And how long has this been going on for?\n[Patient] Um, it's been, it's been a few weeks now. Um, been about three weeks or something.\n[Doctor] Right, OK. And, is this just on one side, or both sides?\n[Patient] Just one side, just on my left side, I've noticed that the hearing's kind of gone down a bit.\n[Doctor] Right, OK. And your face feeling numb, where exactly is that? Which part of your face? Can you, can you show me with your finger?\n[Patient] \n[Patient] Yeah, so again it's the left side, it's kind of like around my left ear, and kind of, along here. So like, my jawline's just all feeling a bit numb round here.\n[Doctor] Right, OK. OK. Um, has anything else happened, um, in this time? Any other symptoms you have at all?\n[Patient] Not that I, not that I've noticed, .\n[Doctor] \n[Patient] I think, occasionally noticed a, ringing in my ear. Um.\n[Doctor] Some, some ringing in your ear. OK.\n[Patient] , yeah it's .\n[Doctor] Sure, OK. Um, and um, have you had any weakness or numbness, down the, in the rest of the body at all?\n[Patient] No, no, no, no, nothing like that.\n[Doctor] OK. Have you had any difficulty swallowing?\n[Patient] No.\n[Doctor] And, have you had any difficulty speaking?\n[Patient] No, no.\n[Doctor] Have you noticed any problems with your vision, at all?\n[Patient] No, that's all good.\n[Doctor] OK. Uh, and do you have the numbness present right now?\n[Patient] Uh, yeah. It kind of, kind of, there quite often, so, all the time. So yeah, right now it feels very, doesn't feel like when I touch this side of my face.\n[Doctor] Sure. Sure, OK. Alright, um, just going back to the kind of feeling in, in the ear, um, do you have any discharge coming from that ear at all?\n[Patient] No, nothing, nothing coming out.\n[Doctor] K. Any pain in the ear, or from the ear?\n[Patient] Uh, no, don't think so.\n[Doctor] Right, OK. And um, have you had any fever at all?\n[Patient] No, nothing like that.\n[Doctor] And, do you, um, have any itchiness in the ear?\n[Patient] \n[Doctor] Do you use cotton buds to kind of clean your ears out?\n[Patient] Pardon? Ohh, no, no, no, don't use cottons buds, like that.\n[Doctor] No. Alright. OK. Alright. Um, need to, need to ask a few other general questions. Um, do you have any other illnesses at all?\n[Patient] Um, I've, well I've got kind of, been told I have polyps in my nose in the past and, occasionally get them kind of . Um, that, that's all fine and, you know I take a Rennie's if I need to, and if my nose polyps are playing up I've got a spray. Um.\n[Doctor] \n[Patient] Other than that I think they said, ages ago, I had something called, can't quite remember but, labyrinthitis, something like that, but again, nothing, nothing ongoing.\n[Doctor] Sure. Sure, OK. So, are you on any regular medication? You mentioned the spray for your nose.\n[Patient] Yeah, so, no, uh, I only take the, spray for my nose when I need it for, and um, sometimes take like Rennies, but I just get that from the chemist.\n[Doctor] Sure. and, and the spray for your nose, where do you get that from? Is that from a doctor?\n[Patient] Uh, yeah, they gave me a prescription ages ago.\n[Doctor] Yeah. Do you remember the name of the spray, at all?\n[Patient] Unfortunately I don't, sorry.\n[Doctor] that's alright. That's alright. Uh, and you're not on any other medication at all?\n[Patient] No.\n[Doctor] No, OK. Do you have any , any allergies to any medication?\n[Patient] Uh, no just Latex.\n[Doctor] Latex, OK. Alright, that's good to know. Um, and um, in terms of your family, are there any kind of illnesses within your family at all?\n[Patient] My brother had, Neurofibromatosis, I think it is. Um, other than that everyone else is OK.\n[Doctor] Right, OK.\n[Doctor] OK, good. That's good. Um, and in, in terms of your own kind of background now, are you, are you working at the moment?\n[Patient] Yeah, so I'm a, I'm a jockey, um, but, because of all the kind of, these symptoms I've been getting, especially sometimes when I get a ringing, I can feel a bit dizzy. Ohh, I've just had to do far less training. So, kind of beginning to, yeah, impacting work, um, a little bit now.\n[Doctor] OK. So you have to excuse my ignorance, you mean, jockey like with horses? Is that what you're talking about? Yeah. Alright, OK. Fine. Um, great. Um, uh, and, uh, do you live alone?\n[Patient] Yeah, yeah.\n[Patient] Um, I, uh, live with my partner.\n[Doctor] Uh, OK. Right, um, do you have any pets at all at home?\n[Patient] No, no pets.\n[Doctor] OK, fine. OK so, alright. Um, Is there anything else that you wanted to tell me about what's been going on, recently?\n[Patient] Uh, no, just like, like I said, like the ringing um, occasionally and, when I get that I can sometimes feel a bit dizzy but, the main thing is really the, lack of hearing, and the numbness that's got me like, yeah, no idea what's going on there.\n[Doctor] \n[Doctor] OK, fine. Alright. Um, So, , what I think , go on.\n[Patient] I mean, there was just like, there was one thing I think just, 'cause I can panic and you can look online, get a bit, frantic.\n[Doctor] \n[Patient] , I guess what I'm trying to think is, you know, is there something particularly serious that, you know, will need to be sorted and. Obviously, really, anything can just make you really frantic . Hopefully nothing , so serious I will die from it, I don't know I just, I think got myself in a pickle.\n[Doctor] \n[Doctor] OK. so um, uh, obviously we're limited in terms of assessment via the video, uh, portal.\n[Patient] Mmm.\n[Doctor] um, from what you've told me, this doesn't seem to be you know, anything um, that you're gonna die from. However, I would like you to be assessed in a clinic today.\n[Patient] OK.\n[Doctor] OK? I ,would like you to come to one of my clinics. I would like a GP to assess you. what you're, what you're describing might be something called Bell's Palsy. OK? Um,\n[Patient] OK.\n[Patient] Yeah.\n[Doctor] We can go into that, explaining what that is, if um, if that's confirmed on, on physical examination. But um, that's not usually a life-threatening problem.\n[Patient] OK.\n[Doctor] But, um, part of the reason why I'd like you to come in, it's just that we can do a, a what we call a, a neurological examination just to make sure there's nothing else going on, and confirm that might be the diagnosis. Have a look, have a look inside the ear, see if there's any, , anything to see within the ear.\n[Patient] OK.\n[Patient] \n[Doctor] So, um, um, so, in answer to your question. No, I don't think that you need to worry about that, I , think you know , preliminarily I can, I can reassure you.\n[Patient] OK.\n[Doctor] However, , in order to definitively reassure you, I, I think you need a physical examination today, OK. , so what I wanna do, is I'm gonna send a message to our admin team, I'll ask them, to book you in for a face-to-face appointment in one of our clinics.\n[Patient] Mm-hmm.\n[Patient] Yeah, that's fine.\n[Patient] OK.\n[Doctor] Um, within Central London. OK, and then you can ring the , the support team number, I'll leave that number in your notes. And you can ring them after five minutes, and then they'll slot you in to a place that's convenient for you, OK.\n[Patient] OK. Yeah.\n[Patient] , that's fine.\n[Doctor] All right. So, someone will see you, and hopefully you will be able to reassure further but, please make sure the appointment gets done today.\n[Patient] OK, yep, I will do, that's fine. Thank you very much.\n[Doctor] All right then. OK. Nice to see you. Take care.\n[Patient] Bye bye.\n[Doctor] Bye.",
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"start": 31.66162,
"end": 35.02242,
"text": "OK, great. Um, so how can I help you today?",
"speaker": "Doctor"
},
{
"start": 35.31881,
"end": 44.7246,
"text": "Um, so, just been having some, um, problems with my hearing, I can't really hear very well, and my , noticed that my face has been feeling a bit numb recently.",
"speaker": "Patient"
},
{
"start": 44.9096,
"end": 48.85695,
"text": "Right, OK. OK. And how long has this been going on for?",
"speaker": "Doctor"
},
{
"start": 49.14488,
"end": 54.81154,
"text": "Um, it's been, it's been a few weeks now. Um, been about three weeks or something.",
"speaker": "Patient"
},
{
"start": 54.90956,
"end": 59.00729,
"text": "Right, OK. And, is this just on one side, or both sides?",
"speaker": "Doctor"
},
{
"start": 59.52168,
"end": 64.13037,
"text": "Just one side, just on my left side, I've noticed that the hearing's kind of gone down a bit.",
"speaker": "Patient"
},
{
"start": 64.58622,
"end": 72.37566,
"text": "Right, OK. And your face feeling numb, where exactly is that? Which part of your face? Can you, can you show me with your finger?",
"speaker": "Doctor"
},
{
"start": 68.73906,
"end": 69.73906,
"text": "",
"speaker": "Patient"
},
{
"start": 72.31735,
"end": 81.59412,
"text": "Yeah, so again it's the left side, it's kind of like around my left ear, and kind of, along here. So like, my jawline's just all feeling a bit numb round here.",
"speaker": "Patient"
},
{
"start": 81.20269,
"end": 88.56128,
"text": "Right, OK. OK. Um, has anything else happened, um, in this time? Any other symptoms you have at all?",
"speaker": "Doctor"
},
{
"start": 88.94194,
"end": 92.5063,
"text": "Not that I, not that I've noticed, .",
"speaker": "Patient"
},
{
"start": 89.12457,
"end": 95.65134,
"text": " ",
"speaker": "Doctor"
},
{
"start": 93.55518,
"end": 97.61645,
"text": "I think, occasionally noticed a, ringing in my ear. Um.",
"speaker": "Patient"
},
{
"start": 96.93949,
"end": 99.11242,
"text": "Some, some ringing in your ear. OK.",
"speaker": "Doctor"
},
{
"start": 98.92492,
"end": 100.75007,
"text": ", yeah it's .",
"speaker": "Patient"
},
{
"start": 101.26279,
"end": 109.55599,
"text": "Sure, OK. Um, and um, have you had any weakness or numbness, down the, in the rest of the body at all?",
"speaker": "Doctor"
},
{
"start": 109.51892,
"end": 111.50713,
"text": "No, no, no, no, nothing like that.",
"speaker": "Patient"
},
{
"start": 111.45072,
"end": 113.99958,
"text": "OK. Have you had any difficulty swallowing?",
"speaker": "Doctor"
},
{
"start": 114.40642,
"end": 115.13032,
"text": "No.",
"speaker": "Patient"
},
{
"start": 115.67627,
"end": 117.66123,
"text": "And, have you had any difficulty speaking?",
"speaker": "Doctor"
},
{
"start": 118.18903,
"end": 119.03417,
"text": "No, no.",
"speaker": "Patient"
},
{
"start": 119.2101,
"end": 121.78152,
"text": "Have you noticed any problems with your vision, at all?",
"speaker": "Doctor"
},
{
"start": 122.36738,
"end": 123.65205,
"text": "No, that's all good.",
"speaker": "Patient"
},
{
"start": 123.64618,
"end": 127.04182,
"text": "OK. Uh, and do you have the numbness present right now?",
"speaker": "Doctor"
},
{
"start": 127.76799,
"end": 137.23175,
"text": "Uh, yeah. It kind of, kind of, there quite often, so, all the time. So yeah, right now it feels very, doesn't feel like when I touch this side of my face.",
"speaker": "Patient"
},
{
"start": 136.90177,
"end": 146.63857,
"text": "Sure. Sure, OK. Alright, um, just going back to the kind of feeling in, in the ear, um, do you have any discharge coming from that ear at all?",
"speaker": "Doctor"
},
{
"start": 146.92739,
"end": 149.07232,
"text": "No, nothing, nothing coming out.",
"speaker": "Patient"
},
{
"start": 147.90172,
"end": 151.28517,
"text": "K. Any pain in the ear, or from the ear?",
"speaker": "Doctor"
},
{
"start": 151.91894,
"end": 154.60996,
"text": "Uh, no, don't think so.",
"speaker": "Patient"
},
{
"start": 154.54832,
"end": 158.64605,
"text": "Right, OK. And um, have you had any fever at all?",
"speaker": "Doctor"
},
{
"start": 159.14477,
"end": 160.44912,
"text": "No, nothing like that.",
"speaker": "Patient"
},
{
"start": 160.89483,
"end": 164.26257,
"text": "And, do you, um, have any itchiness in the ear?",
"speaker": "Doctor"
},
{
"start": 163.81143,
"end": 166.26071,
"text": "",
"speaker": "Patient"
},
{
"start": 165.38287,
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"text": " Do you use cotton buds to kind of clean your ears out?",
"speaker": "Doctor"
},
{
"start": 170.57066,
"end": 173.79662,
"text": "Pardon? Ohh, no, no, no, don't use cottons buds, like that.",
"speaker": "Patient"
},
{
"start": 172.05203,
"end": 180.99185,
"text": "No. Alright. OK. Alright. Um, need to, need to ask a few other general questions. Um, do you have any other illnesses at all?",
"speaker": "Doctor"
},
{
"start": 181.87987,
"end": 199.13024,
"text": "Um, I've, well I've got kind of, been told I have polyps in my nose in the past and, occasionally get them kind of . Um, that, that's all fine and, you know I take a Rennie's if I need to, and if my nose polyps are playing up I've got a spray. Um.",
"speaker": "Patient"
},
{
"start": 190.83391,
"end": 191.52564,
"text": "",
"speaker": "Doctor"
},
{
"start": 199.13024,
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"text": "Other than that I think they said, ages ago, I had something called, can't quite remember but, labyrinthitis, something like that, but again, nothing, nothing ongoing.",
"speaker": "Patient"
},
{
"start": 205.74835,
"end": 212.31504,
"text": " Sure. Sure, OK. So, are you on any regular medication? You mentioned the spray for your nose.",
"speaker": "Doctor"
},
{
"start": 211.86935,
"end": 220.56499,
"text": "Yeah, so, no, uh, I only take the, spray for my nose when I need it for, and um, sometimes take like Rennies, but I just get that from the chemist.",
"speaker": "Patient"
},
{
"start": 220.26237,
"end": 223.90898,
"text": "Sure. and, and the spray for your nose, where do you get that from? Is that from a doctor?",
"speaker": "Doctor"
},
{
"start": 224.08673,
"end": 226.43455,
"text": "Uh, yeah, they gave me a prescription ages ago.",
"speaker": "Patient"
},
{
"start": 226.3601,
"end": 229.20219,
"text": "Yeah. Do you remember the name of the spray, at all?",
"speaker": "Doctor"
},
{
"start": 229.30412,
"end": 231.18817,
"text": "Unfortunately I don't, sorry.",
"speaker": "Patient"
},
{
"start": 230.29994,
"end": 233.97662,
"text": " that's alright. That's alright. Uh, and you're not on any other medication at all?",
"speaker": "Doctor"
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{
"start": 233.89832,
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"text": "No.",
"speaker": "Patient"
},
{
"start": 234.69842,
"end": 237.87886,
"text": "No, OK. Do you have any , any allergies to any medication?",
"speaker": "Doctor"
},
{
"start": 238.17368,
"end": 239.86933,
"text": "Uh, no just Latex.",
"speaker": "Patient"
},
{
"start": 240.07435,
"end": 248.04424,
"text": "Latex, OK. Alright, that's good to know. Um, and um, in terms of your family, are there any kind of illnesses within your family at all?",
"speaker": "Doctor"
},
{
"start": 248.2988,
"end": 254.91279,
"text": "My brother had, Neurofibromatosis, I think it is. Um, other than that everyone else is OK.",
"speaker": "Patient"
},
{
"start": 252.06678,
"end": 253.17204,
"text": "Right, OK.",
"speaker": "Doctor"
},
{
"start": 254.99159,
"end": 261.93141,
"text": "OK, good. That's good. Um, and in, in terms of your own kind of background now, are you, are you working at the moment?",
"speaker": "Doctor"
},
{
"start": 262.18814,
"end": 280.36203,
"text": "Yeah, so I'm a, I'm a jockey, um, but, because of all the kind of, these symptoms I've been getting, especially sometimes when I get a ringing, I can feel a bit dizzy. Ohh, I've just had to do far less training. So, kind of beginning to, yeah, impacting work, um, a little bit now.",
"speaker": "Patient"
},
{
"start": 281.03715,
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"text": "OK. So you have to excuse my ignorance, you mean, jockey like with horses? Is that what you're talking about? Yeah. Alright, OK. Fine. Um, great. Um, uh, and, uh, do you live alone?",
"speaker": "Doctor"
},
{
"start": 284.72435,
"end": 286.20261,
"text": "Yeah, yeah.",
"speaker": "Patient"
},
{
"start": 291.57941,
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"text": "Um, I, uh, live with my partner.",
"speaker": "Patient"
},
{
"start": 294.72826,
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"text": "Uh, OK. Right, um, do you have any pets at all at home?",
"speaker": "Doctor"
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{
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"text": "No, no pets.",
"speaker": "Patient"
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{
"start": 299.60696,
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"text": "OK, fine. OK so, alright. Um, Is there anything else that you wanted to tell me about what's been going on, recently?",
"speaker": "Doctor"
},
{
"start": 306.95621,
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"text": "Uh, no, just like, like I said, like the ringing um, occasionally and, when I get that I can sometimes feel a bit dizzy but, the main thing is really the, lack of hearing, and the numbness that's got me like, yeah, no idea what's going on there.",
"speaker": "Patient"
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"speaker": "Doctor"
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{
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"text": "OK, fine. Alright. Um, So, , what I think , go on.",
"speaker": "Doctor"
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{
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"text": "I mean, there was just like, there was one thing I think just, 'cause I can panic and you can look online, get a bit, frantic.",
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"speaker": "Doctor"
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{
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"text": ", I guess what I'm trying to think is, you know, is there something particularly serious that, you know, will need to be sorted and. Obviously, really, anything can just make you really frantic . Hopefully nothing , so serious I will die from it, I don't know I just, I think got myself in a pickle.",
"speaker": "Patient"
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"start": 345.44991,
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"text": "",
"speaker": "Doctor"
},
{
"start": 348.78073,
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"text": "OK. so um, uh, obviously we're limited in terms of assessment via the video, uh, portal.",
"speaker": "Doctor"
},
{
"start": 357.18804,
"end": 358.01412,
"text": "Mmm.",
"speaker": "Patient"
},
{
"start": 357.28551,
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"text": " um, from what you've told me, this doesn't seem to be you know, anything um, that you're gonna die from. However, I would like you to be assessed in a clinic today.",
"speaker": "Doctor"
},
{
"start": 363.30397,
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"text": "OK.",
"speaker": "Patient"
},
{
"start": 367.75058,
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"text": "OK? I ,would like you to come to one of my clinics. I would like a GP to assess you. what you're, what you're describing might be something called Bell's Palsy. OK? Um,",
"speaker": "Doctor"
},
{
"start": 372.27498,
"end": 372.69527,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 375.89817,
"end": 376.71907,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 378.2167,
"end": 387.87832,
"text": "We can go into that, explaining what that is, if um, if that's confirmed on, on physical examination. But um, that's not usually a life-threatening problem.",
"speaker": "Doctor"
},
{
"start": 384.02859,
"end": 385.02859,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 387.87832,
"end": 402.14316,
"text": "But, um, part of the reason why I'd like you to come in, it's just that we can do a, a what we call a, a neurological examination just to make sure there's nothing else going on, and confirm that might be the diagnosis. Have a look, have a look inside the ear, see if there's any, , anything to see within the ear.",
"speaker": "Doctor"
},
{
"start": 388.07207,
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"text": "OK.",
"speaker": "Patient"
},
{
"start": 396.15902,
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"text": "",
"speaker": "Patient"
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{
"start": 402.14316,
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"text": "So, um, um, so, in answer to your question. No, I don't think that you need to worry about that, I , think you know , preliminarily I can, I can reassure you.",
"speaker": "Doctor"
},
{
"start": 402.22747,
"end": 402.90789,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 411.30602,
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"text": "However, , in order to definitively reassure you, I, I think you need a physical examination today, OK. , so what I wanna do, is I'm gonna send a message to our admin team, I'll ask them, to book you in for a face-to-face appointment in one of our clinics.",
"speaker": "Doctor"
},
{
"start": 411.41987,
"end": 412.18799,
"text": "Mm-hmm.",
"speaker": "Patient"
},
{
"start": 416.76769,
"end": 417.76769,
"text": "Yeah, that's fine.",
"speaker": "Patient"
},
{
"start": 423.56479,
"end": 424.56479,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 423.82553,
"end": 434.69015,
"text": "Um, within Central London. OK, and then you can ring the , the support team number, I'll leave that number in your notes. And you can ring them after five minutes, and then they'll slot you in to a place that's convenient for you, OK.",
"speaker": "Doctor"
},
{
"start": 429.28942,
"end": 432.07517,
"text": "OK. Yeah.",
"speaker": "Patient"
},
{
"start": 434.30391,
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"text": ", that's fine.",
"speaker": "Patient"
},
{
"start": 435.6868,
"end": 442.442,
"text": "All right. So, someone will see you, and hopefully you will be able to reassure further but, please make sure the appointment gets done today.",
"speaker": "Doctor"
},
{
"start": 442.52129,
"end": 445.14448,
"text": "OK, yep, I will do, that's fine. Thank you very much.",
"speaker": "Patient"
},
{
"start": 444.97583,
"end": 447.2465,
"text": "All right then. OK. Nice to see you. Take care.",
"speaker": "Doctor"
},
{
"start": 447.40535,
"end": 448.40535,
"text": "Bye bye.",
"speaker": "Patient"
},
{
"start": 448.10364,
"end": 448.81793,
"text": "Bye.",
"speaker": "Doctor"
}
],
"doctor_utterances": "Hi there. Good morning! Hello. I, I'm Doctor . Nice to see you. Hi. Um, so, before we start your appointment, could I confirm your full name and date of birth, if that's OK? You're OK, fine. So, you're you're forty years old, you said, yeah? Perfect, OK. Um, are you in a private place where you're OK to speak at the moment? OK, great. Um, so how can I help you today? Right, OK. OK. And how long has this been going on for? Right, OK. And, is this just on one side, or both sides? Right, OK. And your face feeling numb, where exactly is that? Which part of your face? Can you, can you show me with your finger? Right, OK. OK. Um, has anything else happened, um, in this time? Any other symptoms you have at all? Some, some ringing in your ear. OK. Sure, OK. Um, and um, have you had any weakness or numbness, down the, in the rest of the body at all? OK. Have you had any difficulty swallowing? And, have you had any difficulty speaking? Have you noticed any problems with your vision, at all? OK. Uh, and do you have the numbness present right now? Sure. Sure, OK. Alright, um, just going back to the kind of feeling in, in the ear, um, do you have any discharge coming from that ear at all? K. Any pain in the ear, or from the ear? Right, OK. And um, have you had any fever at all? And, do you, um, have any itchiness in the ear? Do you use cotton buds to kind of clean your ears out? No. Alright. OK. Alright. Um, need to, need to ask a few other general questions. Um, do you have any other illnesses at all? Sure. Sure, OK. So, are you on any regular medication? You mentioned the spray for your nose. Sure. and, and the spray for your nose, where do you get that from? Is that from a doctor? Yeah. Do you remember the name of the spray, at all? that's alright. That's alright. Uh, and you're not on any other medication at all? No, OK. Do you have any , any allergies to any medication? Latex, OK. Alright, that's good to know. Um, and um, in terms of your family, are there any kind of illnesses within your family at all? Right, OK. OK, good. That's good. Um, and in, in terms of your own kind of background now, are you, are you working at the moment? OK. So you have to excuse my ignorance, you mean, jockey like with horses? Is that what you're talking about? Yeah. Alright, OK. Fine. Um, great. Um, uh, and, uh, do you live alone? Uh, OK. Right, um, do you have any pets at all at home? OK, fine. OK so, alright. Um, Is there anything else that you wanted to tell me about what's been going on, recently? OK, fine. Alright. Um, So, , what I think , go on. OK. so um, uh, obviously we're limited in terms of assessment via the video, uh, portal. um, from what you've told me, this doesn't seem to be you know, anything um, that you're gonna die from. However, I would like you to be assessed in a clinic today. OK? I ,would like you to come to one of my clinics. I would like a GP to assess you. what you're, what you're describing might be something called Bell's Palsy. OK? Um, We can go into that, explaining what that is, if um, if that's confirmed on, on physical examination. But um, that's not usually a life-threatening problem. But, um, part of the reason why I'd like you to come in, it's just that we can do a, a what we call a, a neurological examination just to make sure there's nothing else going on, and confirm that might be the diagnosis. Have a look, have a look inside the ear, see if there's any, , anything to see within the ear. So, um, um, so, in answer to your question. No, I don't think that you need to worry about that, I , think you know , preliminarily I can, I can reassure you. However, , in order to definitively reassure you, I, I think you need a physical examination today, OK. , so what I wanna do, is I'm gonna send a message to our admin team, I'll ask them, to book you in for a face-to-face appointment in one of our clinics. Um, within Central London. OK, and then you can ring the , the support team number, I'll leave that number in your notes. And you can ring them after five minutes, and then they'll slot you in to a place that's convenient for you, OK. All right. So, someone will see you, and hopefully you will be able to reassure further but, please make sure the appointment gets done today. All right then. OK. Nice to see you. Take care. Bye.",
"patient_utterances": "Hello? Hi. . Nice to meet you. Hello. Uh, yeah. Uh, Mary Richards. Uh, and my, I'm forty years old. So. Yep. Um, so, just been having some, um, problems with my hearing, I can't really hear very well, and my , noticed that my face has been feeling a bit numb recently. Um, it's been, it's been a few weeks now. Um, been about three weeks or something. Just one side, just on my left side, I've noticed that the hearing's kind of gone down a bit. Yeah, so again it's the left side, it's kind of like around my left ear, and kind of, along here. So like, my jawline's just all feeling a bit numb round here. Not that I, not that I've noticed, . I think, occasionally noticed a, ringing in my ear. Um. , yeah it's . No, no, no, no, nothing like that. No. No, no. No, that's all good. Uh, yeah. It kind of, kind of, there quite often, so, all the time. So yeah, right now it feels very, doesn't feel like when I touch this side of my face. No, nothing, nothing coming out. Uh, no, don't think so. No, nothing like that. Pardon? Ohh, no, no, no, don't use cottons buds, like that. Um, I've, well I've got kind of, been told I have polyps in my nose in the past and, occasionally get them kind of . Um, that, that's all fine and, you know I take a Rennie's if I need to, and if my nose polyps are playing up I've got a spray. Um. Other than that I think they said, ages ago, I had something called, can't quite remember but, labyrinthitis, something like that, but again, nothing, nothing ongoing. Yeah, so, no, uh, I only take the, spray for my nose when I need it for, and um, sometimes take like Rennies, but I just get that from the chemist. Uh, yeah, they gave me a prescription ages ago. Unfortunately I don't, sorry. No. Uh, no just Latex. My brother had, Neurofibromatosis, I think it is. Um, other than that everyone else is OK. Yeah, so I'm a, I'm a jockey, um, but, because of all the kind of, these symptoms I've been getting, especially sometimes when I get a ringing, I can feel a bit dizzy. Ohh, I've just had to do far less training. So, kind of beginning to, yeah, impacting work, um, a little bit now. Yeah, yeah. Um, I, uh, live with my partner. No, no pets. Uh, no, just like, like I said, like the ringing um, occasionally and, when I get that I can sometimes feel a bit dizzy but, the main thing is really the, lack of hearing, and the numbness that's got me like, yeah, no idea what's going on there. I mean, there was just like, there was one thing I think just, 'cause I can panic and you can look online, get a bit, frantic. , I guess what I'm trying to think is, you know, is there something particularly serious that, you know, will need to be sorted and. Obviously, really, anything can just make you really frantic . Hopefully nothing , so serious I will die from it, I don't know I just, I think got myself in a pickle. Mmm. OK. OK. Yeah. OK. OK. OK. Mm-hmm. Yeah, that's fine. OK. OK. Yeah. , that's fine. OK, yep, I will do, that's fine. Thank you very much. Bye bye.",
"num_turns": 102,
"reference_note": "{\"day\": 2, \"consultation\": 3, \"presenting_complaint\": \"I can't hear very well and my face is a bit numb\", \"note\": \"Hx: 1 week history of left side difficulty hearing and facial numbness\\nNo dysphagia, dysarthria, no unilateral weakness/numbness in the rest of the body, no visual disturbances \\nNo ear pain, ear discharge, fever, itchiness or cotton bud use.\\nSlight tinnitus at times in this period- not continuous\\nNumbness and difficulty hearing present now \\nPmhx: labyrinthitis, heart burn, nasal polyps\\nDH: Rennies PRN OTC, nasal spray PRN (pt not sure of name)\\nAllergies: latex allergy\\nNo FH of note\\nEx: no facial asymmetry, looks well, normal facial expressions and movements\\nImp: ? Bell's Palsy- need to rule out any other focal neurology\\nPlan: for face to face review today for neurological examination and ear examination\\nPt to ring support line for GP F2f slot\\nPt understands and is happy with plan\\n\", \"highlights\": [\"difficulty hearing\", \"facial numbness\", \"tinnitus\", \"latex allergy\", \"no facial assymetry\"]}",
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"consultation_id": "day2_consultation04",
"dialogue": "[Doctor] Hi there. Good morning.\n[Patient] Hello.\n[Doctor] Um, I'm Doctor Deen Mirza from GP at Hand. Nice to see you.\n[Patient] Lovely to meet you.\n[Doctor] OK. So, before we start your appointment. Can I please confirm your full name and date of birth?\n[Patient] Uh my name is, Tracy Chapman, and, um, my date of birth is. God . , I'm forty five.\n[Doctor] Just tell me how old you are. , OK. Uh, and could you just confirm the first line of your address, and your postcode?\n[Patient] Uh, fifteen Babylon Street. Um, W six five .\n[Doctor] That's great, OK, thank you. Um, are you in a private place where you're OK to speak at the moment?\n[Patient] Yes.\n[Doctor] OK, fantastic. All right, so tell me what's been going on. You said you're, a bit short of breath. Is that right?\n[Patient] Yeah, yeah, feeling very sort of breathless recently. Um, like, I don't know, whenever I like breathe deeply, I, it sort of catches in, in the, right-hand side of my back.\n[Doctor] Right, OK, OK. And how long has this been going on for now?\n[Patient] Just, just today really.\n[Doctor] Right, OK. Any other symptoms at the same time, uh, that you've had this pain?\n[Patient] Um, well I've had a , I've got a bit of slight fever, um, and, and, uh, well like, I coughed up a bit of blood on, on two occasions.\n[Doctor] \n[Doctor] Right, OK.\n[Patient] what that means.\n[Doctor] OK, all right. , well it might, it might all be connected then. Um, and um, yesterday, before this, all of this, were you completely fine?\n[Patient] Um, yeah, yeah, kind of, I , I, I can sort of feel my heart beating, but , other than that, no, sort of fine.\n[Doctor] \n[Doctor] OK. So you can feel your heart kind of, um, beating a little bit, bit faster, do you think than normal? Is that?\n[Patient] \n[Patient] , I don't know I can just sort of feel it, more , you know. Um, but I've, I've also, I've been feeling a bit, like a bit tired at work.\n[Doctor] OK. Sure.\n[Patient] Haven't really been, like exercising has been a bit difficult, because I've been feeling tired. Um, and, , yeah performing, , performing daily activities has, has been a bit harder than usual.\n[Doctor] \n[Doctor] . OK, all right. , and um, how long has that been for? The tiredness and, you know, , not wanting to exercise and.\n[Patient] Um, , only after, only for a couple of weeks or so.\n[Doctor] Couple of weeks, OK. And then, and the last day or so that's when you get the cough and the pain in the side? And you've cough blood, OK, all right. Um, you said you felt a bit warm. , have you measured your temperature at all?\n[Patient] Yep.\n[Patient] Um, with the back of my, my hand, yes.\n[Doctor] just with that, OK, fair enough, all right. Um, OK. And now, can I just ask? Um, do you smoke at all?\n[Patient] Uh, no.\n[Doctor] OK. What do you work as?\n[Patient] Um, I work in an office, just a, desk job.\n[Doctor] OK, all right. And, um, do you live alone?\n[Patient] Uh, yes.\n[Doctor] Yeah. In a flat or a house?\n[Patient] Flat.\n[Doctor] OK. Do you have any pets?\n[Patient] Cat.\n[Doctor] A cat, OK. Um, uh, uh, are you on, any medication at all? Regular medication?\n[Patient] \n[Patient] Uh, yeah, um, , Methotrexate, Methotrexate, that's.\n[Doctor] Methotrexate. OK. , what are you on that for?\n[Patient] Um, I've, I've got SLE.\n[Doctor] SLE, OK. Do you have any other , diagnoses? Any other illnesses at all?\n[Patient] No.\n[Doctor] Right, OK. Um, and do you have any allergies to any medication?\n[Patient] No.\n[Doctor] Any other allergies at all?\n[Patient] No.\n[Doctor] OK. So, um, you're on, you're taking Methotrexate at the moment. When was the last time you had Methotrexate?\n[Patient] Uh, this morning.\n[Doctor] Ohh, you had it this morning. OK, ohh right, all right.\n[Patient] \n[Doctor] OK. Um , um, couple of things I'd like to do in order to try and um, get an idea of how, unwell you are. OK. Um, the first thing I'd like to do, is to try and measure your pulse. So, what, the way we're gonna do this, is that, if you're, if I can get you to try and locate the pulse in your wrist. . Not everyone can do this, so don't worry if you can't. But if you, if you can tell me whether you can feel the regular pulse. It's just under the thumb. If you put two fingers up and down like that, you might be able to feel the pulse.\n[Patient] I've got it.\n[Doctor] You got it, OK. Are you sure?\n[Patient] Yep.\n[Doctor] All right. So what I'm going to do, is I'm going to tell you when to start counting, and when to stop counting OK. So I'll just get my stopwatch up.\n[Doctor] OK. So if you can, um, you've still got the pulse?\n[Patient] Yep.\n[Doctor] OK. So if you can start counting, now please.\n[Patient] One, two, three. Five, six, , eight, , ten, . \n[Doctor] If you can stop now, . That, I think that was about eleven or twelve. Um, so that would make your heart rate about, sixty six to seventy four, that's, that's OK, good. Fantastic. And the next thing I'd like you to try and do, OK. Um, it depends on the lighting, so it may not be possible. But the next thing I'd like you to try and do is just, to get you to squeeze the tip of your finger. And then let me see how quickly the redness come back. OK, so if you can see what I'm doing now. My finger's come, right behind the screen, I'm squeezing it, OK. , just watch me first, it's all right, just watch me first. Yeah, I'm, I'm squeezing it. And then you can see, that, it goes, pale and then it goes back to the normal red colour, OK. So if I can get you just to put your finger up to the, your camera. And then with the other hand, just try and squeeze it, and see.\n[Patient] You look like you've got very good circulation. \n[Doctor] OK, perfect, that's great. Thank you so much. The last thing I'd like to do, is I'd like , to , try and have a look down your throat. OK. Are, are you doing this consultation via, um, a phone or a , laptop?\n[Patient] Phone.\n[Doctor] A phone?\n[Patient] rested it on my laptop, so I think we're good to go.\n[Doctor] , sorry, say that again.\n[Patient] Got it rested the laptop but I can.\n[Doctor] OK, , OK. So if you, if you, um, position your device up above your head, put your head back, mouth open wide, and let me see if I can have a . That's, fantastic. And say ah.\n[Patient] Ah.\n[Doctor] Perfect. Thank you for that. Excellent.\n[Patient] Lovely.\n[Doctor] OK. Last thing, is if I can get you to feel inside your neck. Just on the sides here, OK, um, by your Adam's apple. Tell me whether you can feel any enlarged glands or not.\n[Patient] No, they feel pretty normal to me.\n[Doctor] . OK.\n[Patient] I think.\n[Doctor] All right. Um. Now, um, uh, . Sorry, I've forgotten your name.\n[Patient] Um, Doris.\n[Doctor] Doris, OK Doris. Um, so, so Doris, um, what, what I think we need to do, is um. This sounds like you might have a chest infection. OK. If you're coughing up blood, and you're feeling your heart racing. Um. Uh, I think, you need to be examined today, someone needs to listen to your chest. And, um, maybe check your blood pressure as well, check that, you're stable. I have to say examining you now, from what limited, examination I could do online.\n[Patient] \n[Doctor] You're, everything does seem to be OK, in terms of, you, you don't seem acutely unstable. However, if you've got, this kind of pain, um, when taking a deep breath in and you're coughing up blood. We do, do, we do need to assess you to figure out whether you have a Pneumonia or chest infection. And um, that would involve someone listening to your chest with a stethoscope, and you may need um, an antibiotic. Uh, there's one thing I need to ask you. Have you been, on any long-haul flight recently?\n[Patient] \n[Patient] No, no.\n[Doctor] No, OK. Have you ever had any clots in your legs, or clots in your lung? Blood clots?\n[Patient] Not that I know of, no.\n[Doctor] No, OK. Anyone in the family have that?\n[Patient] No.\n[Doctor] No, OK. All right. Um, what I think we'll do is um, we'll arrange for you to get reviewed in a clinic today. OK. Um, I would like someone to listen to your chest, and check your blood pressure. And to, to recheck your pulse as well. Just make sure, and check your temperature, make sure all those parameters are OK. You may well need an antibiotic, OK. Um, do you have any allergies to any antibiotics?\n[Patient] No.\n[Doctor] No, OK. Um, I, I'm not, I'm gonna, not, I'm not going to prescribe anything for you now, because I think you need to have that, basic assessment first. Um, before we proceed to the next step. But the, that's what I would predict the next step might be. Um, I'm going to leave the number in the notes for this appointment, for you to ring our support team. And then, they will, book you in for a face-to-face appointment with one of our GPs today. And then, they'll do that assessment, and then we'll take it from there, OK.\n[Patient] OK.\n[Patient] But we don't think I'm dying of lung cancer.\n[Doctor] Um, uh, given the, the way in which you uh, have presented now. Just one day, with a fever and, this slight pain, , concurrent with the, the blood in the, the, the flem. That's not usually how lung cancer is presented. It's more insidious, over a longer period of time, with other symptoms. Um, however, we might need to get some investigations to exclude that. It depends on the examination finding, when we see you.\n[Patient] OK.\n[Doctor] All right. , are you worried about lung cancer?\n[Patient] Well you know, you start coughing up blood and you think you're, gonna, die of lung cancer, so.\n[Doctor] . Sure, of course yeah. So, just remind me how old you are again. I'm sorry.\n[Patient] Forty five.\n[Doctor] Forty five, OK. It's something we do need to be cognisant of, OK. Um, and, we may end up having to do a follow-up chest X-ray, if things don't settle down. But at the moment, it, it seems more like a chest infection, rather than a lung cancer.\n[Patient] That's good to know.\n[Doctor] Yeah, that, that is good to know, yeah, so that's, 'cause that's easier to treat. But we still need to make sure that things are OK because, chest infections can become nasty as well. It can lead to infection inside the body, , we want to avoid that as well. So, let's get you checked out today, and hopefully we can put your mind to rest, and get you on the right course of treatment.\n[Patient] Yep.\n[Patient] Perfect. Thank you very much.\n[Doctor] All right, you're welcome. All right, take care then. All the best.\n[Patient] \n[Doctor] Bye.",
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"text": "OK, all right. , well it might, it might all be connected then. Um, and um, yesterday, before this, all of this, were you completely fine?",
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"text": "Haven't really been, like exercising has been a bit difficult, because I've been feeling tired. Um, and, , yeah performing, , performing daily activities has, has been a bit harder than usual.",
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"text": "Um, , only after, only for a couple of weeks or so.",
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"text": "Couple of weeks, OK. And then, and the last day or so that's when you get the cough and the pain in the side? And you've cough blood, OK, all right. Um, you said you felt a bit warm. , have you measured your temperature at all?",
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"text": "OK, all right. And, um, do you live alone?",
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"text": "Uh, yes.",
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"text": "A cat, OK. Um, uh, uh, are you on, any medication at all? Regular medication?",
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"text": "Uh, yeah, um, , Methotrexate, Methotrexate, that's.",
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"text": "Methotrexate. OK. , what are you on that for?",
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"text": "Um, I've, I've got SLE.",
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"text": "SLE, OK. Do you have any other , diagnoses? Any other illnesses at all?",
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"text": "No.",
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"text": "Right, OK. Um, and do you have any allergies to any medication?",
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"text": "OK. So, um, you're on, you're taking Methotrexate at the moment. When was the last time you had Methotrexate?",
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"text": "Uh, this morning.",
"speaker": "Patient"
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"text": "Ohh, you had it this morning. OK, ohh right, all right.",
"speaker": "Doctor"
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"text": "OK. Um , um, couple of things I'd like to do in order to try and um, get an idea of how, unwell you are. OK. Um, the first thing I'd like to do, is to try and measure your pulse. So, what, the way we're gonna do this, is that, if you're, if I can get you to try and locate the pulse in your wrist. . Not everyone can do this, so don't worry if you can't. But if you, if you can tell me whether you can feel the regular pulse. It's just under the thumb. If you put two fingers up and down like that, you might be able to feel the pulse.",
"speaker": "Doctor"
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"text": "All right. So what I'm going to do, is I'm going to tell you when to start counting, and when to stop counting OK. So I'll just get my stopwatch up.",
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"text": "OK. So if you can, um, you've still got the pulse?",
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"text": "Yep.",
"speaker": "Patient"
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{
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"text": "OK. So if you can start counting, now please.",
"speaker": "Doctor"
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{
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"text": "If you can stop now, . That, I think that was about eleven or twelve. Um, so that would make your heart rate about, sixty six to seventy four, that's, that's OK, good. Fantastic. And the next thing I'd like you to try and do, OK. Um, it depends on the lighting, so it may not be possible. But the next thing I'd like you to try and do is just, to get you to squeeze the tip of your finger. And then let me see how quickly the redness come back. OK, so if you can see what I'm doing now. My finger's come, right behind the screen, I'm squeezing it, OK. , just watch me first, it's all right, just watch me first. Yeah, I'm, I'm squeezing it. And then you can see, that, it goes, pale and then it goes back to the normal red colour, OK. So if I can get you just to put your finger up to the, your camera. And then with the other hand, just try and squeeze it, and see.",
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"text": " You look like you've got very good circulation. ",
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"text": "OK, perfect, that's great. Thank you so much. The last thing I'd like to do, is I'd like , to , try and have a look down your throat. OK. Are, are you doing this consultation via, um, a phone or a , laptop?",
"speaker": "Doctor"
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"start": 340.91078,
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"text": "Phone.",
"speaker": "Patient"
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{
"start": 342.02017,
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"text": "A phone?",
"speaker": "Doctor"
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{
"start": 342.30604,
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"text": " rested it on my laptop, so I think we're good to go.",
"speaker": "Patient"
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{
"start": 346.98044,
"end": 348.30156,
"text": ", sorry, say that again.",
"speaker": "Doctor"
},
{
"start": 348.66268,
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"text": "Got it rested the laptop but I can.",
"speaker": "Patient"
},
{
"start": 348.75913,
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"text": " OK, , OK. So if you, if you, um, position your device up above your head, put your head back, mouth open wide, and let me see if I can have a . That's, fantastic. And say ah.",
"speaker": "Doctor"
},
{
"start": 359.62512,
"end": 362.03114,
"text": "Ah.",
"speaker": "Patient"
},
{
"start": 360.3376,
"end": 363.93647,
"text": " Perfect. Thank you for that. Excellent.",
"speaker": "Doctor"
},
{
"start": 364.01611,
"end": 364.76799,
"text": "Lovely.",
"speaker": "Patient"
},
{
"start": 364.50199,
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"text": "OK. Last thing, is if I can get you to feel inside your neck. Just on the sides here, OK, um, by your Adam's apple. Tell me whether you can feel any enlarged glands or not.",
"speaker": "Doctor"
},
{
"start": 376.22667,
"end": 378.44472,
"text": "No, they feel pretty normal to me.",
"speaker": "Patient"
},
{
"start": 377.05993,
"end": 379.12187,
"text": ". OK.",
"speaker": "Doctor"
},
{
"start": 379.64021,
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"text": "I think.",
"speaker": "Patient"
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"text": "All right. Um. Now, um, uh, . Sorry, I've forgotten your name.",
"speaker": "Doctor"
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"text": "Um, Doris.",
"speaker": "Patient"
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"text": " Doris, OK Doris. Um, so, so Doris, um, what, what I think we need to do, is um. This sounds like you might have a chest infection. OK. If you're coughing up blood, and you're feeling your heart racing. Um. Uh, I think, you need to be examined today, someone needs to listen to your chest. And, um, maybe check your blood pressure as well, check that, you're stable. I have to say examining you now, from what limited, examination I could do online.",
"speaker": "Doctor"
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"start": 408.89595,
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"text": "You're, everything does seem to be OK, in terms of, you, you don't seem acutely unstable. However, if you've got, this kind of pain, um, when taking a deep breath in and you're coughing up blood. We do, do, we do need to assess you to figure out whether you have a Pneumonia or chest infection. And um, that would involve someone listening to your chest with a stethoscope, and you may need um, an antibiotic. Uh, there's one thing I need to ask you. Have you been, on any long-haul flight recently?",
"speaker": "Doctor"
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"start": 432.33212,
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"speaker": "Patient"
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"text": "No, no.",
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"text": "No, OK. Have you ever had any clots in your legs, or clots in your lung? Blood clots?",
"speaker": "Doctor"
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{
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"text": "Not that I know of, no.",
"speaker": "Patient"
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"text": "No, OK. Anyone in the family have that?",
"speaker": "Doctor"
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"text": "No.",
"speaker": "Patient"
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"start": 453.33815,
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"text": "No, OK. All right. Um, what I think we'll do is um, we'll arrange for you to get reviewed in a clinic today. OK. Um, I would like someone to listen to your chest, and check your blood pressure. And to, to recheck your pulse as well. Just make sure, and check your temperature, make sure all those parameters are OK. You may well need an antibiotic, OK. Um, do you have any allergies to any antibiotics?",
"speaker": "Doctor"
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"text": "No.",
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"text": "No, OK. Um, I, I'm not, I'm gonna, not, I'm not going to prescribe anything for you now, because I think you need to have that, basic assessment first. Um, before we proceed to the next step. But the, that's what I would predict the next step might be. Um, I'm going to leave the number in the notes for this appointment, for you to ring our support team. And then, they will, book you in for a face-to-face appointment with one of our GPs today. And then, they'll do that assessment, and then we'll take it from there, OK.",
"speaker": "Doctor"
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"text": "OK.",
"speaker": "Patient"
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"text": "But we don't think I'm dying of lung cancer.",
"speaker": "Patient"
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{
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"text": "Um, uh, given the, the way in which you uh, have presented now. Just one day, with a fever and, this slight pain, , concurrent with the, the blood in the, the, the flem. That's not usually how lung cancer is presented. It's more insidious, over a longer period of time, with other symptoms. Um, however, we might need to get some investigations to exclude that. It depends on the examination finding, when we see you.",
"speaker": "Doctor"
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{
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"text": "OK.",
"speaker": "Patient"
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{
"start": 530.31836,
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"text": "All right. , are you worried about lung cancer?",
"speaker": "Doctor"
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"start": 532.58809,
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"text": "Well you know, you start coughing up blood and you think you're, gonna, die of lung cancer, so.",
"speaker": "Patient"
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{
"start": 536.95413,
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"text": ". Sure, of course yeah. So, just remind me how old you are again. I'm sorry.",
"speaker": "Doctor"
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"text": "Forty five.",
"speaker": "Patient"
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"text": "Forty five, OK. It's something we do need to be cognisant of, OK. Um, and, we may end up having to do a follow-up chest X-ray, if things don't settle down. But at the moment, it, it seems more like a chest infection, rather than a lung cancer.",
"speaker": "Doctor"
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"start": 554.95658,
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"text": "That's good to know.",
"speaker": "Patient"
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{
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"text": "Yeah, that, that is good to know, yeah, so that's, 'cause that's easier to treat. But we still need to make sure that things are OK because, chest infections can become nasty as well. It can lead to infection inside the body, , we want to avoid that as well. So, let's get you checked out today, and hopefully we can put your mind to rest, and get you on the right course of treatment.",
"speaker": "Doctor"
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"text": "Yep.",
"speaker": "Patient"
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"text": "Perfect. Thank you very much.",
"speaker": "Patient"
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"text": "All right, you're welcome. All right, take care then. All the best.",
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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. So, before we start your appointment. Can I please confirm your full name and date of birth? Just tell me how old you are. , OK. Uh, and could you just confirm the first line of your address, and your postcode? That's great, OK, thank you. Um, are you in a private place where you're OK to speak at the moment? OK, fantastic. All right, so tell me what's been going on. You said you're, a bit short of breath. Is that right? Right, OK, OK. And how long has this been going on for now? Right, OK. Any other symptoms at the same time, uh, that you've had this pain? Right, OK. OK, all right. , well it might, it might all be connected then. Um, and um, yesterday, before this, all of this, were you completely fine? OK. So you can feel your heart kind of, um, beating a little bit, bit faster, do you think than normal? Is that? OK. Sure. . OK, all right. , and um, how long has that been for? The tiredness and, you know, , not wanting to exercise and. Couple of weeks, OK. And then, and the last day or so that's when you get the cough and the pain in the side? And you've cough blood, OK, all right. Um, you said you felt a bit warm. , have you measured your temperature at all? just with that, OK, fair enough, all right. Um, OK. And now, can I just ask? Um, do you smoke at all? OK. What do you work as? OK, all right. And, um, do you live alone? Yeah. In a flat or a house? OK. Do you have any pets? A cat, OK. Um, uh, uh, are you on, any medication at all? Regular medication? Methotrexate. OK. , what are you on that for? SLE, OK. Do you have any other , diagnoses? Any other illnesses at all? Right, OK. Um, and do you have any allergies to any medication? Any other allergies at all? OK. So, um, you're on, you're taking Methotrexate at the moment. When was the last time you had Methotrexate? Ohh, you had it this morning. OK, ohh right, all right. OK. Um , um, couple of things I'd like to do in order to try and um, get an idea of how, unwell you are. OK. Um, the first thing I'd like to do, is to try and measure your pulse. So, what, the way we're gonna do this, is that, if you're, if I can get you to try and locate the pulse in your wrist. . Not everyone can do this, so don't worry if you can't. But if you, if you can tell me whether you can feel the regular pulse. It's just under the thumb. If you put two fingers up and down like that, you might be able to feel the pulse. You got it, OK. Are you sure? All right. So what I'm going to do, is I'm going to tell you when to start counting, and when to stop counting OK. So I'll just get my stopwatch up. OK. So if you can, um, you've still got the pulse? OK. So if you can start counting, now please. If you can stop now, . That, I think that was about eleven or twelve. Um, so that would make your heart rate about, sixty six to seventy four, that's, that's OK, good. Fantastic. And the next thing I'd like you to try and do, OK. Um, it depends on the lighting, so it may not be possible. But the next thing I'd like you to try and do is just, to get you to squeeze the tip of your finger. And then let me see how quickly the redness come back. OK, so if you can see what I'm doing now. My finger's come, right behind the screen, I'm squeezing it, OK. , just watch me first, it's all right, just watch me first. Yeah, I'm, I'm squeezing it. And then you can see, that, it goes, pale and then it goes back to the normal red colour, OK. So if I can get you just to put your finger up to the, your camera. And then with the other hand, just try and squeeze it, and see. OK, perfect, that's great. Thank you so much. The last thing I'd like to do, is I'd like , to , try and have a look down your throat. OK. Are, are you doing this consultation via, um, a phone or a , laptop? A phone? , sorry, say that again. OK, , OK. So if you, if you, um, position your device up above your head, put your head back, mouth open wide, and let me see if I can have a . That's, fantastic. And say ah. Perfect. Thank you for that. Excellent. OK. Last thing, is if I can get you to feel inside your neck. Just on the sides here, OK, um, by your Adam's apple. Tell me whether you can feel any enlarged glands or not. . OK. All right. Um. Now, um, uh, . Sorry, I've forgotten your name. Doris, OK Doris. Um, so, so Doris, um, what, what I think we need to do, is um. This sounds like you might have a chest infection. OK. If you're coughing up blood, and you're feeling your heart racing. Um. Uh, I think, you need to be examined today, someone needs to listen to your chest. And, um, maybe check your blood pressure as well, check that, you're stable. I have to say examining you now, from what limited, examination I could do online. You're, everything does seem to be OK, in terms of, you, you don't seem acutely unstable. However, if you've got, this kind of pain, um, when taking a deep breath in and you're coughing up blood. We do, do, we do need to assess you to figure out whether you have a Pneumonia or chest infection. And um, that would involve someone listening to your chest with a stethoscope, and you may need um, an antibiotic. Uh, there's one thing I need to ask you. Have you been, on any long-haul flight recently? No, OK. Have you ever had any clots in your legs, or clots in your lung? Blood clots? No, OK. Anyone in the family have that? No, OK. All right. Um, what I think we'll do is um, we'll arrange for you to get reviewed in a clinic today. OK. Um, I would like someone to listen to your chest, and check your blood pressure. And to, to recheck your pulse as well. Just make sure, and check your temperature, make sure all those parameters are OK. You may well need an antibiotic, OK. Um, do you have any allergies to any antibiotics? No, OK. Um, I, I'm not, I'm gonna, not, I'm not going to prescribe anything for you now, because I think you need to have that, basic assessment first. Um, before we proceed to the next step. But the, that's what I would predict the next step might be. Um, I'm going to leave the number in the notes for this appointment, for you to ring our support team. And then, they will, book you in for a face-to-face appointment with one of our GPs today. And then, they'll do that assessment, and then we'll take it from there, OK. Um, uh, given the, the way in which you uh, have presented now. Just one day, with a fever and, this slight pain, , concurrent with the, the blood in the, the, the flem. That's not usually how lung cancer is presented. It's more insidious, over a longer period of time, with other symptoms. Um, however, we might need to get some investigations to exclude that. It depends on the examination finding, when we see you. All right. , are you worried about lung cancer? . Sure, of course yeah. So, just remind me how old you are again. I'm sorry. Forty five, OK. It's something we do need to be cognisant of, OK. Um, and, we may end up having to do a follow-up chest X-ray, if things don't settle down. But at the moment, it, it seems more like a chest infection, rather than a lung cancer. Yeah, that, that is good to know, yeah, so that's, 'cause that's easier to treat. But we still need to make sure that things are OK because, chest infections can become nasty as well. It can lead to infection inside the body, , we want to avoid that as well. So, let's get you checked out today, and hopefully we can put your mind to rest, and get you on the right course of treatment. All right, you're welcome. All right, take care then. All the best. Bye.",
"patient_utterances": "Hello. Lovely to meet you. Uh my name is, Tracy Chapman, and, um, my date of birth is. God . , I'm forty five. Uh, fifteen Babylon Street. Um, W six five . Yes. Yeah, yeah, feeling very sort of breathless recently. Um, like, I don't know, whenever I like breathe deeply, I, it sort of catches in, in the, right-hand side of my back. Just, just today really. Um, well I've had a , I've got a bit of slight fever, um, and, and, uh, well like, I coughed up a bit of blood on, on two occasions. what that means. Um, yeah, yeah, kind of, I , I, I can sort of feel my heart beating, but , other than that, no, sort of fine. , I don't know I can just sort of feel it, more , you know. Um, but I've, I've also, I've been feeling a bit, like a bit tired at work. Haven't really been, like exercising has been a bit difficult, because I've been feeling tired. Um, and, , yeah performing, , performing daily activities has, has been a bit harder than usual. Um, , only after, only for a couple of weeks or so. Yep. Um, with the back of my, my hand, yes. Uh, no. Um, I work in an office, just a, desk job. Uh, yes. Flat. Cat. Uh, yeah, um, , Methotrexate, Methotrexate, that's. Um, I've, I've got SLE. No. No. No. Uh, this morning. I've got it. Yep. Yep. One, two, three. Five, six, , eight, , ten, . You look like you've got very good circulation. Phone. rested it on my laptop, so I think we're good to go. Got it rested the laptop but I can. Ah. Lovely. No, they feel pretty normal to me. I think. Um, Doris. No, no. Not that I know of, no. No. No. OK. But we don't think I'm dying of lung cancer. OK. Well you know, you start coughing up blood and you think you're, gonna, die of lung cancer, so. Forty five. That's good to know. Yep. Perfect. Thank you very much. ",
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"reference_note": "{\"day\": 2, \"consultation\": 4, \"presenting_complaint\": \"I feel breathless\", \"note\": \"1 day hx of SOB, slight pleuritic pain (right side), feeling warm (not measured temperature), 2 episodes haemoptysis and palpitations.\\nNo recent long haul flights\\nNo FH or PMHx of DVT/Pes\\nHas been feeling TATT/ fatigue for the last few weeks preceding these symptoms\\nPmhx: SLE\\nDH: on methotrexate\\nNo allergies\\nSH lives alone, has cat, works in an office\\nEx: pulse around 66, normal CRT, throat inspection normal, pt cant feel any LNs in neck, not SOB, looks well\\nImp: probable LRTI, possibly secondary to immunosuppression\\nPlan: needs F2f gp assessment today to listen to chest and check BP/pulse/ temp\\nMay also need blood tests to check immune status in view of methotrexate\\n\", \"highlights\": [\"\"]}",
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"dialogue": "[Doctor] Hi, Hi there, good morning.\n[Patient] Hi, good morning.\n[Doctor] Um, I'm Doctor Dean Resor from . Nice to see you. \n[Patient] That's the same thing.\n[Doctor] OK great! So before we start your appointment, could you please confirm your full name and date of birth?\n[Patient] Yeah sure! Um, my name is Jim Gowers and I was born in nineteen fifty eight uh on the eighth of August.\n[Doctor] \n[Doctor] That's great. Thank you so much for that. Um, you look a lot younger, so, um\n[Patient] Yeah.\n[Doctor] Does that, that would make you roughly about fifty years old, fifty one, fifty one years old. Is that is that correct or?\n[Patient] Yeah, yeah around that. Yeah about sixty, yeah.\n[Doctor] Six, OK, perfect. All right. So, um, nice to see see you this morning. Are you in a private place where you are OK to speak freely?\n[Patient] Yep.\n[Patient] Yes, I am. Yeah.\n[Doctor] OK fantastic! So um, how can I help you today?\n[Patient] Um, yeah. I was, I was having, um, a bit of chest discomfort. So, I was doing some gardening, um, a couple of hours ago. And I felt not exactly a pain but um like a a pressure on my chest, um, feels like someone sitting on my chest. Um, and, I've noticed, um, a bit of nausea, not, no vomiting but, um, I'm pretty sweaty, um, short of breath, and it kind of feels like someone's sitting on my chest.\n[Doctor] Right, OK. Now, do you have those these symptoms right now or have they gone off now?\n[Patient] Um, no, they're still present.\n[Doctor] OK. So, you've still got the chest discomfort right now?\n[Patient] Yes.\n[Doctor] OK, um.\n[Doctor] We're probably gonna have to call an ambulance for you. OK. So what I'm gonna do, is I'm gonna task my colleague next to me to sort that out. While we do that I'm gonna ask you a few more questions, OK?\n[Patient] OK.\n[Patient] Mmm, sure.\n[Doctor] We're gonna a bit more information to the, to help the ambulance team when they, when they arrive, OK.\n[Patient] Sure.\n[Doctor] So just to, just to double check, um, where exactly in the chest is the pain?\n[Patient] Um, it's in the, uh, middle of my chest, um, over, uh, yeah, my my pecs, so, um, yeah but not not necessarily to one side, um, and it's quite diffuse pain.\n[Doctor] Is, is it spreading anywhere else, like down into your arm, up to the jaw, in your neck, anything like that?\n[Patient] Yeah. It's, it's, um, mainly in my left arm, er, it's feeling a little bit, um, er, painful, and, and in my shoulder as well.\n[Doctor] Right, OK. Do you remember what you were doing at the time? \n[Patient] Uh yes, so it started uh just when I was gardening. So nothing that was too strenuous um I was just kneeling down and Uh, yeah, wasn't running or anything, it wasn't during any physical exercise.\n[Doctor] Sure, OK. And, and how much activity do you do normally? Do you walk a lot or do you run or do you do anything?\n[Patient] No, I don't, I, I generally don't do much activity at all, um, you know.\n[Doctor] Have you had this before?\n[Patient] No, this is the first time, actually.\n[Doctor] Right, OK. Can are you aware of any palpitations, like your heart beating faster or more prominently than normal?\n[Patient] Yeah.\n[Patient] Um, yeah. It's, it's beating a bit faster now. I think that's 'cause I'm a little bit stressed. Um, about the situation but I haven't noticed it, um, beating faster than usual, um, and I did today.\n[Doctor] \n[Doctor] \n[Doctor] So, I know you're stressed but, but we've got an ambulance coming on the way, OK? So um, we'll take care of everything, so don't, don't worry. Who's in the house with you at the moment?\n[Patient] Yeah.\n[Patient] OK, thank you.\n[Patient] Uh, no, no one's in the house at the moment.\n[Doctor] OK. Um, and is your front door open?\n[Patient] Uh, yes, it's open.\n[Doctor] OK so maybe we'll, we'll speak maybe in the hallway to the front door. Have the front door open so that, in case people need access, they could access you.\n[Patient] Yeah, yeah .\n[Doctor] Alright. Um, so, um, uh, are you a smoker at all?\n[Patient] Uh, yeah, I smoke, um, a fair bit so I smoke about ten cigarettes, uh, a day. Um, yeah.\n[Doctor] How long have you been smoking for?\n[Patient] Uh, for the past fifteen years.\n[Doctor] Fifteen years, OK. Um, do you have, um, high blood pressure or high cholesterol or diabetes or anything?\n[Patient] Yeah.\n[Patient] Yeah, I have high blood, uh, blood pressure, but, um, not diabetes.\n[Doctor] OK. Have you ever had your cholesterol checked?\n[Patient] No.\n[Doctor] OK, all right. Um, now anyone in your wider in, in your family, sorry, in your parents, did either of them have any heart problems, or heart attacks, or anything like that?\n[Patient] Yes.\n[Patient] Um, yes, so, my, um, father died of a heart attack, um, and my mother had some heart problems.\n[Doctor] \n[Doctor] OK. Uh, I'm sorry to hear about your father. Can you remember what age roughly he was when he had, he had the heart attack?\n[Patient] Um, he was about my age.\n[Doctor] Right so just under sixty, around sixty.\n[Patient] Yes, around sixty, yes.\n[Doctor] Yeah, OK, alright. Um, do you drink much alcohol?\n[Patient] Um, yeah, I drink, um, about, per week, probably about seven or eight pints a week.\n[Doctor] OK, is that a, a beer you're talking about, yeah?\n[Patient] Ohh. Yeah, yes.\n[Doctor] Uh, I, I can't tell from the video, are you overweight?\n[Patient] Um, yes, I'm overweight, yeah.\n[Doctor] Right, OK. Alright. Um, uh now um, you, do you normally live alone?\n[Patient] Yeah.\n[Patient] Uh, yeah. I live alone, uh, at the moment. Yeah, uh, it's just me in the house.\n[Doctor] Sure, OK, and, and, uh, are you working at the moment?\n[Patient] Yeah yeah, I, I work, yeah.\n[Doctor] Right, what do you work as?\n[Patient] Um, I work as a restaurant owner. So I own a sushi shop.\n[Doctor] Right, OK. Alright. Um, so, um, the, the symptoms that you've described to me\n[Patient] Yeah.\n[Doctor] Um, they indicate the possibility of, um, a heart attack. OK? So, I'm not saying you definitely have a heart attack, but we, that, it's our number one priority to exclude that.\n[Patient] OK.\n[Doctor] OK, so ambulance team will be with you very shortly. I'm gonna stay on the line with you until they come.\n[Patient] OK, yeah.\n[Doctor] OK. when they come, what they'll do is, they're gonna put some stickers on your chest and do an ECG.\n[Patient] OK, yeah. Thank you.\n[Doctor] And then decide where to take you after that, OK? \n[Patient] OK.\n[Patient] OK, no.\n[Doctor] And um, what, what, uh, can I just double check? Do you have, um, any allergies to any medication?\n[Patient] Yes, actually, I have, um, an allergy to aspirin.\n[Doctor] Right, OK.\n[Patient] Yeah, and no other allergies.\n[Doctor] Sure. Uh, what's the nature of that allergy to aspirin? Do you, does it, does it cause you heartburn? Or is it like an allergic reaction?\n[Patient] Um Yeah, uh, it's an allergic reaction, so I swell up, um, a bit, but, um, nothing life threatening. Um, I've, I, sometimes even have it and it's, it's a, it's a mild reaction to it.\n[Doctor] OK, all right. It's very important that you communicate that to the hospital.\n[Patient] Yeah.\n[Doctor] Um, the detail you just told me, because, um, we, we may need to consider aspirin despite allergy, OK?\n[Patient] OK.\n[Patient] Ohh, OK.\n[Doctor] Um, alright, um, now in terms of, um, what happens from here\n[Patient] OK.\n[Doctor] That team will assess you and then they may take you into one hospital or another based on how bad , what the ECG looks like and what kind of treatment you might need, OK?\n[Patient] Uh huh.\n[Doctor] Um, what I'm going to do is, we'll stay on the line for the time being, OK, until they come, and then, um, once they come, then I'll hand over to them and I'll explain what's going on, alright?\n[Patient] OK.\n[Patient] OK.\n[Patient] OK, OK, sure.\n[Doctor] OK.\n[Patient] Yeah, thank you.\n[Doctor] we'll end the conversation after the purposes. Is that OK?\n[Patient] Yeah, that's, OK. OK, thank you very much.\n[Doctor] thanks! Bye!\n[Patient] Thank you. Bye.",
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"text": "OK great! So before we start your appointment, could you please confirm your full name and date of birth?",
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"text": "Yeah sure! Um, my name is Jim Gowers and I was born in nineteen fifty eight uh on the eighth of August.",
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"text": "That's great. Thank you so much for that. Um, you look a lot younger, so, um",
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"text": "Does that, that would make you roughly about fifty years old, fifty one, fifty one years old. Is that is that correct or?",
"speaker": "Doctor"
},
{
"start": 36.25532,
"end": 38.91484,
"text": "Yeah, yeah around that. Yeah about sixty, yeah.",
"speaker": "Patient"
},
{
"start": 38.84391,
"end": 45.69609,
"text": "Six, OK, perfect. All right. So, um, nice to see see you this morning. Are you in a private place where you are OK to speak freely?",
"speaker": "Doctor"
},
{
"start": 40.24095,
"end": 40.80614,
"text": "Yep.",
"speaker": "Patient"
},
{
"start": 46.13973,
"end": 47.67599,
"text": "Yes, I am. Yeah.",
"speaker": "Patient"
},
{
"start": 47.37726,
"end": 50.52221,
"text": "OK fantastic! So um, how can I help you today?",
"speaker": "Doctor"
},
{
"start": 51.18238,
"end": 81.69914,
"text": "Um, yeah. I was, I was having, um, a bit of chest discomfort. So, I was doing some gardening, um, a couple of hours ago. And I felt not exactly a pain but um like a a pressure on my chest, um, feels like someone sitting on my chest. Um, and, I've noticed, um, a bit of nausea, not, no vomiting but, um, I'm pretty sweaty, um, short of breath, and it kind of feels like someone's sitting on my chest.",
"speaker": "Patient"
},
{
"start": 82.19841,
"end": 87.54986,
"text": "Right, OK. Now, do you have those these symptoms right now or have they gone off now?",
"speaker": "Doctor"
},
{
"start": 88.09217,
"end": 89.76926,
"text": "Um, no, they're still present.",
"speaker": "Patient"
},
{
"start": 89.7835,
"end": 92.8467,
"text": "OK. So, you've still got the chest discomfort right now?",
"speaker": "Doctor"
},
{
"start": 92.82323,
"end": 93.68597,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 94.95132,
"end": 96.42949,
"text": "OK, um.",
"speaker": "Doctor"
},
{
"start": 98.65648,
"end": 110.49611,
"text": "We're probably gonna have to call an ambulance for you. OK. So what I'm gonna do, is I'm gonna task my colleague next to me to sort that out. While we do that I'm gonna ask you a few more questions, OK?",
"speaker": "Doctor"
},
{
"start": 101.98307,
"end": 102.76098,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 110.28054,
"end": 111.31677,
"text": "Mmm, sure.",
"speaker": "Patient"
},
{
"start": 110.49611,
"end": 115.89627,
"text": " We're gonna a bit more information to the, to help the ambulance team when they, when they arrive, OK.",
"speaker": "Doctor"
},
{
"start": 115.41116,
"end": 116.03774,
"text": "Sure.",
"speaker": "Patient"
},
{
"start": 115.89627,
"end": 120.4624,
"text": "So just to, just to double check, um, where exactly in the chest is the pain?",
"speaker": "Doctor"
},
{
"start": 121.13017,
"end": 133.8541,
"text": "Um, it's in the, uh, middle of my chest, um, over, uh, yeah, my my pecs, so, um, yeah but not not necessarily to one side, um, and it's quite diffuse pain.",
"speaker": "Patient"
},
{
"start": 132.09122,
"end": 139.21876,
"text": " Is, is it spreading anywhere else, like down into your arm, up to the jaw, in your neck, anything like that?",
"speaker": "Doctor"
},
{
"start": 138.84697,
"end": 147.87104,
"text": "Yeah. It's, it's, um, mainly in my left arm, er, it's feeling a little bit, um, er, painful, and, and in my shoulder as well.",
"speaker": "Patient"
},
{
"start": 148.23335,
"end": 152.7588,
"text": "Right, OK. Do you remember what you were doing at the time? ",
"speaker": "Doctor"
},
{
"start": 152.28967,
"end": 165.07781,
"text": "Uh yes, so it started uh just when I was gardening. So nothing that was too strenuous um I was just kneeling down and Uh, yeah, wasn't running or anything, it wasn't during any physical exercise.",
"speaker": "Patient"
},
{
"start": 164.88823,
"end": 171.3785,
"text": "Sure, OK. And, and how much activity do you do normally? Do you walk a lot or do you run or do you do anything?",
"speaker": "Doctor"
},
{
"start": 170.71818,
"end": 176.1967,
"text": "No, I don't, I, I generally don't do much activity at all, um, you know.",
"speaker": "Patient"
},
{
"start": 176.37202,
"end": 178.14749,
"text": "Have you had this before?",
"speaker": "Doctor"
},
{
"start": 178.37793,
"end": 180.65337,
"text": "No, this is the first time, actually.",
"speaker": "Patient"
},
{
"start": 180.97615,
"end": 187.77689,
"text": "Right, OK. Can are you aware of any palpitations, like your heart beating faster or more prominently than normal?",
"speaker": "Doctor"
},
{
"start": 182.22587,
"end": 182.85628,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 188.00145,
"end": 200.27742,
"text": "Um, yeah. It's, it's beating a bit faster now. I think that's 'cause I'm a little bit stressed. Um, about the situation but I haven't noticed it, um, beating faster than usual, um, and I did today.",
"speaker": "Patient"
},
{
"start": 195.94027,
"end": 196.5952,
"text": "",
"speaker": "Doctor"
},
{
"start": 198.28187,
"end": 198.83821,
"text": "",
"speaker": "Doctor"
},
{
"start": 200.42976,
"end": 209.52784,
"text": "So, I know you're stressed but, but we've got an ambulance coming on the way, OK? So um, we'll take care of everything, so don't, don't worry. Who's in the house with you at the moment?",
"speaker": "Doctor"
},
{
"start": 204.36185,
"end": 204.92521,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 207.24142,
"end": 208.31389,
"text": "OK, thank you.",
"speaker": "Patient"
},
{
"start": 209.87914,
"end": 212.00964,
"text": "Uh, no, no one's in the house at the moment.",
"speaker": "Patient"
},
{
"start": 212.44815,
"end": 216.7557,
"text": "OK. Um, and is your front door open?",
"speaker": "Doctor"
},
{
"start": 217.03886,
"end": 218.54614,
"text": "Uh, yes, it's open.",
"speaker": "Patient"
},
{
"start": 218.74499,
"end": 226.48144,
"text": "OK so maybe we'll, we'll speak maybe in the hallway to the front door. Have the front door open so that, in case people need access, they could access you.",
"speaker": "Doctor"
},
{
"start": 225.92333,
"end": 227.5538,
"text": "Yeah, yeah .",
"speaker": "Patient"
},
{
"start": 226.48144,
"end": 230.99058,
"text": "Alright. Um, so, um, uh, are you a smoker at all?",
"speaker": "Doctor"
},
{
"start": 231.4437,
"end": 239.91673,
"text": "Uh, yeah, I smoke, um, a fair bit so I smoke about ten cigarettes, uh, a day. Um, yeah.",
"speaker": "Patient"
},
{
"start": 239.7401,
"end": 241.45158,
"text": "How long have you been smoking for?",
"speaker": "Doctor"
},
{
"start": 241.89505,
"end": 244.55456,
"text": "Uh, for the past fifteen years.",
"speaker": "Patient"
},
{
"start": 244.58204,
"end": 251.17631,
"text": "Fifteen years, OK. Um, do you have, um, high blood pressure or high cholesterol or diabetes or anything?",
"speaker": "Doctor"
},
{
"start": 246.23051,
"end": 246.77922,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 251.59103,
"end": 255.61295,
"text": "Yeah, I have high blood, uh, blood pressure, but, um, not diabetes.",
"speaker": "Patient"
},
{
"start": 255.66543,
"end": 257.85956,
"text": "OK. Have you ever had your cholesterol checked?",
"speaker": "Doctor"
},
{
"start": 258.27247,
"end": 259.14927,
"text": "No.",
"speaker": "Patient"
},
{
"start": 259.3068,
"end": 269.57309,
"text": "OK, all right. Um, now anyone in your wider in, in your family, sorry, in your parents, did either of them have any heart problems, or heart attacks, or anything like that?",
"speaker": "Doctor"
},
{
"start": 265.16406,
"end": 265.88868,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 268.52646,
"end": 276.95444,
"text": "Um, yes, so, my, um, father died of a heart attack, um, and my mother had some heart problems.",
"speaker": "Patient"
},
{
"start": 273.03157,
"end": 273.80367,
"text": "",
"speaker": "Doctor"
},
{
"start": 276.69826,
"end": 282.81089,
"text": "OK. Uh, I'm sorry to hear about your father. Can you remember what age roughly he was when he had, he had the heart attack?",
"speaker": "Doctor"
},
{
"start": 283.05463,
"end": 285.31713,
"text": "Um, he was about my age.",
"speaker": "Patient"
},
{
"start": 285.79979,
"end": 288.79861,
"text": "Right so just under sixty, around sixty.",
"speaker": "Doctor"
},
{
"start": 288.42595,
"end": 290.15788,
"text": "Yes, around sixty, yes.",
"speaker": "Patient"
},
{
"start": 289.66018,
"end": 293.14596,
"text": "Yeah, OK, alright. Um, do you drink much alcohol?",
"speaker": "Doctor"
},
{
"start": 293.57106,
"end": 299.65818,
"text": "Um, yeah, I drink, um, about, per week, probably about seven or eight pints a week.",
"speaker": "Patient"
},
{
"start": 300.00538,
"end": 302.65538,
"text": "OK, is that a, a beer you're talking about, yeah?",
"speaker": "Doctor"
},
{
"start": 302.15116,
"end": 303.61496,
"text": "Ohh. Yeah, yes.",
"speaker": "Patient"
},
{
"start": 304.10654,
"end": 307.58956,
"text": "Uh, I, I can't tell from the video, are you overweight?",
"speaker": "Doctor"
},
{
"start": 308.06599,
"end": 310.32458,
"text": "Um, yes, I'm overweight, yeah.",
"speaker": "Patient"
},
{
"start": 310.4522,
"end": 317.16864,
"text": "Right, OK. Alright. Um, uh now um, you, do you normally live alone?",
"speaker": "Doctor"
},
{
"start": 310.86251,
"end": 311.32073,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 317.94297,
"end": 323.11587,
"text": "Uh, yeah. I live alone, uh, at the moment. Yeah, uh, it's just me in the house.",
"speaker": "Patient"
},
{
"start": 322.82464,
"end": 325.92642,
"text": "Sure, OK, and, and, uh, are you working at the moment?",
"speaker": "Doctor"
},
{
"start": 326.1957,
"end": 328.27548,
"text": "Yeah yeah, I, I work, yeah.",
"speaker": "Patient"
},
{
"start": 328.81468,
"end": 330.33224,
"text": "Right, what do you work as?",
"speaker": "Doctor"
},
{
"start": 330.54367,
"end": 334.8627,
"text": "Um, I work as a restaurant owner. So I own a sushi shop.",
"speaker": "Patient"
},
{
"start": 335.30749,
"end": 342.51626,
"text": "Right, OK. Alright. Um, so, um, the, the symptoms that you've described to me",
"speaker": "Doctor"
},
{
"start": 336.3265,
"end": 336.85546,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 342.51626,
"end": 354.67002,
"text": "Um, they indicate the possibility of, um, a heart attack. OK? So, I'm not saying you definitely have a heart attack, but we, that, it's our number one priority to exclude that.",
"speaker": "Doctor"
},
{
"start": 348.33433,
"end": 349.03125,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 354.67002,
"end": 360.33186,
"text": "OK, so ambulance team will be with you very shortly. I'm gonna stay on the line with you until they come.",
"speaker": "Doctor"
},
{
"start": 355.11722,
"end": 356.24767,
"text": "OK, yeah.",
"speaker": "Patient"
},
{
"start": 360.33186,
"end": 366.81782,
"text": "OK. when they come, what they'll do is, they're gonna put some stickers on your chest and do an ECG.",
"speaker": "Doctor"
},
{
"start": 360.54496,
"end": 362.04017,
"text": "OK, yeah. Thank you.",
"speaker": "Patient"
},
{
"start": 366.81782,
"end": 371.28408,
"text": "And then decide where to take you after that, OK? ",
"speaker": "Doctor"
},
{
"start": 366.94377,
"end": 367.66115,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 370.47285,
"end": 371.63228,
"text": "OK, no.",
"speaker": "Patient"
},
{
"start": 371.28408,
"end": 377.66435,
"text": "And um, what, what, uh, can I just double check? Do you have, um, any allergies to any medication?",
"speaker": "Doctor"
},
{
"start": 377.93694,
"end": 381.11098,
"text": "Yes, actually, I have, um, an allergy to aspirin.",
"speaker": "Patient"
},
{
"start": 382.10601,
"end": 383.51079,
"text": "Right, OK.",
"speaker": "Doctor"
},
{
"start": 382.9806,
"end": 384.99515,
"text": "Yeah, and no other allergies.",
"speaker": "Patient"
},
{
"start": 384.84882,
"end": 392.39503,
"text": "Sure. Uh, what's the nature of that allergy to aspirin? Do you, does it, does it cause you heartburn? Or is it like an allergic reaction?",
"speaker": "Doctor"
},
{
"start": 390.865,
"end": 404.9816,
"text": "Um Yeah, uh, it's an allergic reaction, so I swell up, um, a bit, but, um, nothing life threatening. Um, I've, I, sometimes even have it and it's, it's a, it's a mild reaction to it.",
"speaker": "Patient"
},
{
"start": 405.04366,
"end": 410.17309,
"text": "OK, all right. It's very important that you communicate that to the hospital.",
"speaker": "Doctor"
},
{
"start": 406.24248,
"end": 406.7497,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 410.17309,
"end": 416.852,
"text": "Um, the detail you just told me, because, um, we, we may need to consider aspirin despite allergy, OK?",
"speaker": "Doctor"
},
{
"start": 410.26932,
"end": 410.98896,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 415.22104,
"end": 416.17756,
"text": "Ohh, OK.",
"speaker": "Patient"
},
{
"start": 416.852,
"end": 421.92246,
"text": "Um, alright, um, now in terms of, um, what happens from here",
"speaker": "Doctor"
},
{
"start": 417.24278,
"end": 417.69202,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 421.92246,
"end": 433.32819,
"text": "That team will assess you and then they may take you into one hospital or another based on how bad , what the ECG looks like and what kind of treatment you might need, OK?",
"speaker": "Doctor"
},
{
"start": 422.07628,
"end": 422.76467,
"text": "Uh huh.",
"speaker": "Patient"
},
{
"start": 433.32819,
"end": 443.7434,
"text": "Um, what I'm going to do is, we'll stay on the line for the time being, OK, until they come, and then, um, once they come, then I'll hand over to them and I'll explain what's going on, alright?",
"speaker": "Doctor"
},
{
"start": 433.4319,
"end": 434.19276,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 437.09867,
"end": 437.89576,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 443.35254,
"end": 445.04099,
"text": "OK, OK, sure.",
"speaker": "Patient"
},
{
"start": 445.35425,
"end": 445.92467,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 445.93953,
"end": 446.71488,
"text": "Yeah, thank you.",
"speaker": "Patient"
},
{
"start": 449.07186,
"end": 453.00178,
"text": " we'll end the conversation after the purposes. Is that OK?",
"speaker": "Doctor"
},
{
"start": 451.70794,
"end": 455.19341,
"text": " Yeah, that's, OK. OK, thank you very much.",
"speaker": "Patient"
},
{
"start": 454.81145,
"end": 456.13141,
"text": " thanks! Bye!",
"speaker": "Doctor"
},
{
"start": 456.3338,
"end": 457.44,
"text": "Thank you. Bye.",
"speaker": "Patient"
}
],
"doctor_utterances": " Hi, Hi there, good morning. Um, I'm Doctor Dean Resor from . Nice to see you. OK great! So before we start your appointment, could you please confirm your full name and date of birth? That's great. Thank you so much for that. Um, you look a lot younger, so, um Does that, that would make you roughly about fifty years old, fifty one, fifty one years old. Is that is that correct or? Six, OK, perfect. All right. So, um, nice to see see you this morning. Are you in a private place where you are OK to speak freely? OK fantastic! So um, how can I help you today? Right, OK. Now, do you have those these symptoms right now or have they gone off now? OK. So, you've still got the chest discomfort right now? OK, um. We're probably gonna have to call an ambulance for you. OK. So what I'm gonna do, is I'm gonna task my colleague next to me to sort that out. While we do that I'm gonna ask you a few more questions, OK? We're gonna a bit more information to the, to help the ambulance team when they, when they arrive, OK. So just to, just to double check, um, where exactly in the chest is the pain? Is, is it spreading anywhere else, like down into your arm, up to the jaw, in your neck, anything like that? Right, OK. Do you remember what you were doing at the time? Sure, OK. And, and how much activity do you do normally? Do you walk a lot or do you run or do you do anything? Have you had this before? Right, OK. Can are you aware of any palpitations, like your heart beating faster or more prominently than normal? So, I know you're stressed but, but we've got an ambulance coming on the way, OK? So um, we'll take care of everything, so don't, don't worry. Who's in the house with you at the moment? OK. Um, and is your front door open? OK so maybe we'll, we'll speak maybe in the hallway to the front door. Have the front door open so that, in case people need access, they could access you. Alright. Um, so, um, uh, are you a smoker at all? How long have you been smoking for? Fifteen years, OK. Um, do you have, um, high blood pressure or high cholesterol or diabetes or anything? OK. Have you ever had your cholesterol checked? OK, all right. Um, now anyone in your wider in, in your family, sorry, in your parents, did either of them have any heart problems, or heart attacks, or anything like that? OK. Uh, I'm sorry to hear about your father. Can you remember what age roughly he was when he had, he had the heart attack? Right so just under sixty, around sixty. Yeah, OK, alright. Um, do you drink much alcohol? OK, is that a, a beer you're talking about, yeah? Uh, I, I can't tell from the video, are you overweight? Right, OK. Alright. Um, uh now um, you, do you normally live alone? Sure, OK, and, and, uh, are you working at the moment? Right, what do you work as? Right, OK. Alright. Um, so, um, the, the symptoms that you've described to me Um, they indicate the possibility of, um, a heart attack. OK? So, I'm not saying you definitely have a heart attack, but we, that, it's our number one priority to exclude that. OK, so ambulance team will be with you very shortly. I'm gonna stay on the line with you until they come. OK. when they come, what they'll do is, they're gonna put some stickers on your chest and do an ECG. And then decide where to take you after that, OK? And um, what, what, uh, can I just double check? Do you have, um, any allergies to any medication? Right, OK. Sure. Uh, what's the nature of that allergy to aspirin? Do you, does it, does it cause you heartburn? Or is it like an allergic reaction? OK, all right. It's very important that you communicate that to the hospital. Um, the detail you just told me, because, um, we, we may need to consider aspirin despite allergy, OK? Um, alright, um, now in terms of, um, what happens from here That team will assess you and then they may take you into one hospital or another based on how bad , what the ECG looks like and what kind of treatment you might need, OK? Um, what I'm going to do is, we'll stay on the line for the time being, OK, until they come, and then, um, once they come, then I'll hand over to them and I'll explain what's going on, alright? OK. we'll end the conversation after the purposes. Is that OK? thanks! Bye!",
"patient_utterances": "Hi, good morning. That's the same thing. Yeah sure! Um, my name is Jim Gowers and I was born in nineteen fifty eight uh on the eighth of August. Yeah. Yeah, yeah around that. Yeah about sixty, yeah. Yep. Yes, I am. Yeah. Um, yeah. I was, I was having, um, a bit of chest discomfort. So, I was doing some gardening, um, a couple of hours ago. And I felt not exactly a pain but um like a a pressure on my chest, um, feels like someone sitting on my chest. Um, and, I've noticed, um, a bit of nausea, not, no vomiting but, um, I'm pretty sweaty, um, short of breath, and it kind of feels like someone's sitting on my chest. Um, no, they're still present. Yes. OK. Mmm, sure. Sure. Um, it's in the, uh, middle of my chest, um, over, uh, yeah, my my pecs, so, um, yeah but not not necessarily to one side, um, and it's quite diffuse pain. Yeah. It's, it's, um, mainly in my left arm, er, it's feeling a little bit, um, er, painful, and, and in my shoulder as well. Uh yes, so it started uh just when I was gardening. So nothing that was too strenuous um I was just kneeling down and Uh, yeah, wasn't running or anything, it wasn't during any physical exercise. No, I don't, I, I generally don't do much activity at all, um, you know. No, this is the first time, actually. Yeah. Um, yeah. It's, it's beating a bit faster now. I think that's 'cause I'm a little bit stressed. Um, about the situation but I haven't noticed it, um, beating faster than usual, um, and I did today. Yeah. OK, thank you. Uh, no, no one's in the house at the moment. Uh, yes, it's open. Yeah, yeah . Uh, yeah, I smoke, um, a fair bit so I smoke about ten cigarettes, uh, a day. Um, yeah. Uh, for the past fifteen years. Yeah. Yeah, I have high blood, uh, blood pressure, but, um, not diabetes. No. Yes. Um, yes, so, my, um, father died of a heart attack, um, and my mother had some heart problems. Um, he was about my age. Yes, around sixty, yes. Um, yeah, I drink, um, about, per week, probably about seven or eight pints a week. Ohh. Yeah, yes. Um, yes, I'm overweight, yeah. Yeah. Uh, yeah. I live alone, uh, at the moment. Yeah, uh, it's just me in the house. Yeah yeah, I, I work, yeah. Um, I work as a restaurant owner. So I own a sushi shop. Yeah. OK. OK, yeah. OK, yeah. Thank you. OK. OK, no. Yes, actually, I have, um, an allergy to aspirin. Yeah, and no other allergies. Um Yeah, uh, it's an allergic reaction, so I swell up, um, a bit, but, um, nothing life threatening. Um, I've, I, sometimes even have it and it's, it's a, it's a mild reaction to it. Yeah. OK. Ohh, OK. OK. Uh huh. OK. OK. OK, OK, sure. Yeah, thank you. Yeah, that's, OK. OK, thank you very much. Thank you. Bye.",
"num_turns": 115,
"reference_note": "{\"day\": 2, \"consultation\": 7, \"presenting_complaint\": \"I'm having chest discomfort\", \"note\": \"Onset of chest pain earlier today during gardening (mild physical exertion)\\nCentral chest, radiation to shoulder and neck\\nAssociated nausea, sweatiness, palpitations\\nPAIN STILL PRESENT NOW\\nNo previous similar episodes\\nRisk factors: chronic smoker, FH of IHD, Hypertension, overweight, moderate alcohol intake\\nDH: (mild) allergy to aspirin\\n(forgot to ask about other medication- LAS need to clarify)\\nSH: lives alone\\nEx: haemodynamically stable now, at rest, seated, well perfused via video inspection, not SOB\\nImp: acute cardiac event- needs urgent ECG + trop T\\nLAS blue light called, front door open so they can access if he collapses\\nStayed on line till LAS arrived, handed over to them\\nExplained above\\n\", \"highlights\": [\"chest pain\", \"chronic smoker\", \"FH of IHD\", \"Hypertension\", \"overweight\", \"allergy to aspirin\", \"haemodynamically stable\", \"acute cardiac event\", \"LAS blue light called\"]}",
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"dialogue": "[Doctor] Hi, good morning!\n[Patient] Hello there!\n[Doctor] Hi there, this is uh this is Doctor Dean from .\n[Patient] Hello there? Um, I'm wondering if you can help me today.\n[Doctor] \n[Doctor] OK, sure, I'll try. Before we start, could I please confirm your full name and date of birth?\n[Patient] Yes, it's Sarah Smith, and it's the second of November, um, nineteen ninety two.\n[Doctor] That's great! Thank you, sir. So are you in a private place where you are OK to speak at the moment?\n[Patient] I am indeed, yes.\n[Doctor] OK, so tell me what's been going on.\n[Patient] OK. I, I've really not been feeling so well at all recently. I, I've been struggling with fever for the past week. Yeah, I would say it's about seven days ago. I'm just, I'm really hot and sweaty all the time, and just generally not feeling good.\n[Doctor] OK, alright, sorry to hear that. Now, um, uh, along with this fever and this any other symptoms at all?\n[Patient] Um, I'd say that I'm aching all over really, my muscles are really aching. I'm feeling quite nauseous, uh, so I've not been able to eat very much, and I have been drinking but it's been quite a small amount. Um, and, yeah, just generally quite tired and unwell. I'm sweating during the the the night, I'm quite cold.\n[Doctor] \n[Doctor] OK, all right. Um, and um, so you're having periods of when you're feeling hot, and also periods when you're feeling cold as well.\n[Patient] Yes, yes, quite interchangeable, not really a pattern to it.\n[Doctor] OK, uh, and have you been taking your medication?\n[Patient] Uh, I've been trying to, like, take ibuprofen and paracetamol just to from over the counter, but it's not really helping, just been taking the recommended dose every day of those.\n[Doctor] Sure, and when you say it's not helping, is it bringing the temperature down at all?\n[Patient] Perhaps slightly, yes, but I'm still experiencing these symptoms, so, it does take the edge off a bit.\n[Doctor] OK, alright. And can I just double check have you gotten any cough or cold or sore throat or anything like that?\n[Patient] Mmm, not those sort of symptoms, really. Um\n[Doctor] But which are you getting, other than the ones you've already mentioned to me?\n[Patient] Um, so, I have a habit that it's mainly just the sweating, really, and the and the nausea, uh, that's overtaking all all day and, uh, the aching muscles all over.\n[Doctor] Sure. Have you have you had any ear pain ?\n[Patient] Mmm, no, my ears are fine, actually. I haven't had any problems with my ears.\n[Doctor] OK, um, just, I just need to check for any other causes of infection in the body. So I'm gonna go through some, um, kind of systemic questions. Have you had any diarrhoea?\n[Patient] And not, not really no, not that I can find.\n[Doctor] OK. Have you got any neck stiffness at all?\n[Patient] Um, no. My neck's, my neck's been fine.\n[Doctor] OK.\n[Doctor] Alright. Um, do you have any headache?\n[Patient] Not more than usual, no. Just like the, general headaches but not, just from staring at the screen. No migraines, or anything.\n[Doctor] OK.\n[Doctor] OK, so, you know your normal headache, where is that, in the back of your head or the front of the head?\n[Patient] Uum, it's quite centralized over, over the head.\n[Doctor] OK. and how long have you been having that for?\n[Patient] \n[Patient] It's something that I've struggled with through, years really, just related to a screen use, or, uum, like changes in weather patterns. Yeah, high pressure days, sometimes I struggle with migraines, and headaches.\n[Doctor] \n[Doctor] OK. Um, have you got any rash on your body anywhere at all?\n[Patient] Uh, I haven't noticed any rashes, no.\n[Doctor] Uh, any joints swollen or tender or sore?\n[Patient] Mmm, not really. I mean, I, I often have problems with back pain but not really any other joints.\n[Doctor] OK, alright.\n[Patient] Any problems?\n[Doctor] Alright, and, um, have you got any kind of symptoms down below when you're passing urine?\n[Patient] Uh, no, there's been no problems there.\n[Doctor] OK. Any painful urination at all?\n[Patient] Uh, not at all, no.\n[Doctor] Are you passing urine more often than normal?\n[Patient] Uh, I don't think so, no it's been fairly regular.\n[Doctor] OK. Have you been abroad anywhere recently?\n[Patient] Yes, I have actually.\n[Doctor] Where have you been?\n[Patient] I went to Vietnam. Uh, I came back four weeks ago now.\n[Doctor] OK. Uh, and, um, uh, did you take malaria preventative medication when you went out there?\n[Patient] I did, yes.\n[Doctor] Which one did you take?\n[Patient] Ooo, I can't remember now, off the top of my head.\n[Doctor] Was it a weekly tablet or a daily tablet?\n[Patient] I think it was daily.\n[Doctor] OK, um, and was it one tablet or was it another one that you would take on top of the first one?\n[Patient] I think it was, uh another one that I took on top of the first one.\n[Doctor] OK. And, and what were you doing out in Vietnam? Was it just seeing the cities or going through villages or hiking? What what kind of activities were you doing?\n[Patient] It was quite really, 'cause we were there for a few weeks, and we toured to, uh, several different parts of the country, and uh, the countryside and some cities as well.\n[Doctor] OK. Uh, and um, did you do any kind of, were you in rivers or things like that? Were you, you know, how adventurous were you?\n[Patient] I'm sorry, could you repeat that? I missed that.\n[Doctor] Where you going out into the rivers? Were you going on beaches? I mean how adventurous was your trip?\n[Patient] Yes, it was quite adventurous. We were sort of trekking and, um, cycling, uh, through the farmland and, um, seeing how people lived in a day-to-day life in, in, in farmland.\n[Doctor] Right, OK. Um, thank you for sharing that with me. Now, do you have, um, any other illnesses at all, in the past?\n[Patient] Mmm, as I said I've, I've been struggling with back pain for quite a while, but I haven't really had any, uh, major illnesses in the past, I can think of.\n[Doctor] And that back pain have you, um, have you seen anyone about that?\n[Patient] Yes, yeah, I'm under a physiotherapist at the moment for that.\n[Doctor] Have they, have they give you any kind of diagnosis at all?\n[Patient] Um, they've said that it's, u,h related to long periods of time sitting at a desk, and just, uh, bad posture. So mainly the exercises are focused on improving posture and, and to strengthen the muscles in the back.\n[Doctor] Alright um, are there any illnesses in your family at all?\n[Patient] Hmm, the main one would be, um, heart attack. My, my father passed away of that.\n[Doctor] I'm sorry to hear that. Um, how old was he when that happened?\n[Patient] in his sixties.\n[Patient] Um, sixty eight, I think. Yeah.\n[Doctor] OK. Um, are you on any medication at all?\n[Patient] Uh, just Seroxat.\n[Doctor] OK. Uh, do you have any allergies at all? medication?\n[Patient] No, I've just really pollen allergy. That's all I have.\n[Doctor] OK, so hay fever.\n[Patient] Yes, yeah, just hay fever.\n[Doctor] Alright. Um, are you, um, you're working at the moment?\n[Patient] Uh, I am, yes.\n[Doctor] What do you work at?\n[Patient] I work as a nurse.\n[Doctor] OK, all right. Um, and, um, you're up to date with all the vaccinations, Hepatitis B, and that kind of thing?\n[Patient] Yes, indeed. Yeah.\n[Doctor] OK.\n[Patient] But I'm, I'm really struggling quite a lot at work at the moment. It's been quite difficult, feeling so, uh, tired all the time.\n[Doctor] So, I can .\n[Doctor] Sure, OK. Um, and, are you a, uh, are you a smoker at all?\n[Patient] No, I'm not.\n[Doctor] OK, and ohh do you drink much alcohol?\n[Patient] Mmm, moderate alcohol intake. Yeah, I don't drink too much.\n[Doctor] OK, and how much kind of physical exercise do you do normally?\n[Patient] I try and do, uh, some moderate physical exercise a few times a week.\n[Doctor] OK, that's good, alright, um, so, um What, uh, I think we're gonna need to do is we're gonna need to bring you into one of our clinics. Examine , and we're gonna need to arrange some blood tests as well.\n[Patient] OK.\n[Doctor] OK, um, so, what what I want to do is, the first question I have in my mind is that we need to find a reason for why you've got this fever and these symptoms, because there's no apparent reason from what you've told me.\n[Patient] OK.\n[Doctor] There's no, uh, when someone has got fever and sweats, we want to find out have they got chest infection, have they got a throat infection? Um, and if we can't find a focus of infection, then that's something, that, that's an outstanding question that needs to be answered, OK? Um, the second thing, second factor, is that you've recently come from, uh, Vietnam.\n[Patient] OK.\n[Doctor] And you've had exposure to rural areas. And we need to think about things like malaria or other exotic infections as well. So, um, you're probably gonna need some blood tests. After you've been seen by somebody. Um, now, the urgency of those blood tests depends partly on what we find when we examine you, which is why we're going to go, go for the examination first. You come into one of our clinics in central London, that's one option, and then the the GP there who examines you can then decide on how urgent the blood tests and things are going to be.\n[Patient] OK.\n[Doctor] Or, if it's inconvenient for you to come into central London because you you're living further out, you could actually just attend a local A and E. I'm going to type up what my thought process is and what kind of test I think you need in the notes for this appointment, so you could show that to them at reception. Um, I'll be asking for something called thick and thin blood films, to check for malaria. And inflammatory markers and things like those, technical terms, but they'll understand what that, what I'm talking about. But, um, I, I don't think you can go into work, uh, until we've sorted this out. And we, we, we need to sort this out sooner rather than later.\n[Patient] OK. That sounds great. Thank you so much for your help. I, I think, yeah, I can come straight into central London today to get that sorted.\n[Doctor] OK.\n[Doctor] OK, fine, so what I'm going to do is I will send a message to one of our admin team members asking them to book you in. And if you can ring the number that I leave in your consultation notes, after a few minutes, and then they'll slot you in, and then we can sort things out from there. OK?\n[Patient] That's brilliant. Thank you very much.\n[Doctor] Alright then, OK. Take care then. All the best.\n[Patient] Goodbye.\n[Doctor] Bye.",
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"text": "OK, um, just, I just need to check for any other causes of infection in the body. So I'm gonna go through some, um, kind of systemic questions. Have you had any diarrhoea?",
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"text": "OK. Uh, and, um, uh, did you take malaria preventative medication when you went out there?",
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"text": "I did, yes.",
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"text": "OK. And, and what were you doing out in Vietnam? Was it just seeing the cities or going through villages or hiking? What what kind of activities were you doing?",
"speaker": "Doctor"
},
{
"start": 317.95945,
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"text": "It was quite really, 'cause we were there for a few weeks, and we toured to, uh, several different parts of the country, and uh, the countryside and some cities as well.",
"speaker": "Patient"
},
{
"start": 327.9206,
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"text": "OK. Uh, and um, did you do any kind of, were you in rivers or things like that? Were you, you know, how adventurous were you?",
"speaker": "Doctor"
},
{
"start": 336.16269,
"end": 338.48574,
"text": "I'm sorry, could you repeat that? I missed that.",
"speaker": "Patient"
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{
"start": 337.87683,
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"text": "Where you going out into the rivers? Were you going on beaches? I mean how adventurous was your trip?",
"speaker": "Doctor"
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{
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"text": "Yes, it was quite adventurous. We were sort of trekking and, um, cycling, uh, through the farmland and, um, seeing how people lived in a day-to-day life in, in, in farmland.",
"speaker": "Patient"
},
{
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"text": "Right, OK. Um, thank you for sharing that with me. Now, do you have, um, any other illnesses at all, in the past?",
"speaker": "Doctor"
},
{
"start": 362.89155,
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"text": "Mmm, as I said I've, I've been struggling with back pain for quite a while, but I haven't really had any, uh, major illnesses in the past, I can think of.",
"speaker": "Patient"
},
{
"start": 373.08014,
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"text": "And that back pain have you, um, have you seen anyone about that?",
"speaker": "Doctor"
},
{
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"text": "Yes, yeah, I'm under a physiotherapist at the moment for that.",
"speaker": "Patient"
},
{
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"text": "Have they, have they give you any kind of diagnosis at all?",
"speaker": "Doctor"
},
{
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"text": "Um, they've said that it's, u,h related to long periods of time sitting at a desk, and just, uh, bad posture. So mainly the exercises are focused on improving posture and, and to strengthen the muscles in the back.",
"speaker": "Patient"
},
{
"start": 399.90621,
"end": 403.56316,
"text": "Alright um, are there any illnesses in your family at all?",
"speaker": "Doctor"
},
{
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"text": "Hmm, the main one would be, um, heart attack. My, my father passed away of that.",
"speaker": "Patient"
},
{
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"text": "I'm sorry to hear that. Um, how old was he when that happened?",
"speaker": "Doctor"
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"text": "in his sixties.",
"speaker": "Patient"
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{
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"text": "Um, sixty eight, I think. Yeah.",
"speaker": "Patient"
},
{
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"text": "OK. Um, are you on any medication at all?",
"speaker": "Doctor"
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"text": "Uh, just Seroxat.",
"speaker": "Patient"
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{
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"text": "OK. Uh, do you have any allergies at all? medication?",
"speaker": "Doctor"
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{
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"text": "No, I've just really pollen allergy. That's all I have.",
"speaker": "Patient"
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{
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"text": "OK, so hay fever.",
"speaker": "Doctor"
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"text": "Yes, yeah, just hay fever.",
"speaker": "Patient"
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"text": "Alright. Um, are you, um, you're working at the moment?",
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"text": "Uh, I am, yes.",
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"text": "I work as a nurse.",
"speaker": "Patient"
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"text": "OK, all right. Um, and, um, you're up to date with all the vaccinations, Hepatitis B, and that kind of thing?",
"speaker": "Doctor"
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{
"start": 462.90287,
"end": 464.20864,
"text": "Yes, indeed. Yeah.",
"speaker": "Patient"
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{
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"text": "OK.",
"speaker": "Doctor"
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{
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"text": "But I'm, I'm really struggling quite a lot at work at the moment. It's been quite difficult, feeling so, uh, tired all the time.",
"speaker": "Patient"
},
{
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"text": "So, I can .",
"speaker": "Doctor"
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"text": "Sure, OK. Um, and, are you a, uh, are you a smoker at all?",
"speaker": "Doctor"
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"text": "No, I'm not.",
"speaker": "Patient"
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"text": "OK, and ohh do you drink much alcohol?",
"speaker": "Doctor"
},
{
"start": 482.75505,
"end": 487.96111,
"text": "Mmm, moderate alcohol intake. Yeah, I don't drink too much.",
"speaker": "Patient"
},
{
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"text": "OK, and how much kind of physical exercise do you do normally?",
"speaker": "Doctor"
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"text": "I try and do, uh, some moderate physical exercise a few times a week.",
"speaker": "Patient"
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"end": 509.72401,
"text": "OK, that's good, alright, um, so, um What, uh, I think we're gonna need to do is we're gonna need to bring you into one of our clinics. Examine , and we're gonna need to arrange some blood tests as well.",
"speaker": "Doctor"
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"start": 506.14877,
"end": 507.01146,
"text": "OK.",
"speaker": "Patient"
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{
"start": 509.72401,
"end": 522.91322,
"text": "OK, um, so, what what I want to do is, the first question I have in my mind is that we need to find a reason for why you've got this fever and these symptoms, because there's no apparent reason from what you've told me.",
"speaker": "Doctor"
},
{
"start": 510.72334,
"end": 511.52758,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 522.91322,
"end": 541.75046,
"text": "There's no, uh, when someone has got fever and sweats, we want to find out have they got chest infection, have they got a throat infection? Um, and if we can't find a focus of infection, then that's something, that, that's an outstanding question that needs to be answered, OK? Um, the second thing, second factor, is that you've recently come from, uh, Vietnam.",
"speaker": "Doctor"
},
{
"start": 536.85813,
"end": 537.83924,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 541.75046,
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"text": "And you've had exposure to rural areas. And we need to think about things like malaria or other exotic infections as well. So, um, you're probably gonna need some blood tests. After you've been seen by somebody. Um, now, the urgency of those blood tests depends partly on what we find when we examine you, which is why we're going to go, go for the examination first. You come into one of our clinics in central London, that's one option, and then the the GP there who examines you can then decide on how urgent the blood tests and things are going to be.",
"speaker": "Doctor"
},
{
"start": 562.57795,
"end": 563.46607,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 573.13298,
"end": 605.68783,
"text": "Or, if it's inconvenient for you to come into central London because you you're living further out, you could actually just attend a local A and E. I'm going to type up what my thought process is and what kind of test I think you need in the notes for this appointment, so you could show that to them at reception. Um, I'll be asking for something called thick and thin blood films, to check for malaria. And inflammatory markers and things like those, technical terms, but they'll understand what that, what I'm talking about. But, um, I, I don't think you can go into work, uh, until we've sorted this out. And we, we, we need to sort this out sooner rather than later.",
"speaker": "Doctor"
},
{
"start": 605.92592,
"end": 613.69841,
"text": "OK. That sounds great. Thank you so much for your help. I, I think, yeah, I can come straight into central London today to get that sorted.",
"speaker": "Patient"
},
{
"start": 607.0389,
"end": 607.74858,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 613.28639,
"end": 626.11124,
"text": "OK, fine, so what I'm going to do is I will send a message to one of our admin team members asking them to book you in. And if you can ring the number that I leave in your consultation notes, after a few minutes, and then they'll slot you in, and then we can sort things out from there. OK?",
"speaker": "Doctor"
},
{
"start": 626.53097,
"end": 628.54019,
"text": "That's brilliant. Thank you very much.",
"speaker": "Patient"
},
{
"start": 628.35754,
"end": 630.75143,
"text": "Alright then, OK. Take care then. All the best.",
"speaker": "Doctor"
},
{
"start": 630.78903,
"end": 631.64859,
"text": "Goodbye.",
"speaker": "Patient"
},
{
"start": 631.52012,
"end": 632.06522,
"text": "Bye.",
"speaker": "Doctor"
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],
"doctor_utterances": "Hi, good morning! Hi there, this is uh this is Doctor Dean from . OK, sure, I'll try. Before we start, could I please confirm your full name and date of birth? That's great! Thank you, sir. So are you in a private place where you are OK to speak at the moment? OK, so tell me what's been going on. OK, alright, sorry to hear that. Now, um, uh, along with this fever and this any other symptoms at all? OK, all right. Um, and um, so you're having periods of when you're feeling hot, and also periods when you're feeling cold as well. OK, uh, and have you been taking your medication? Sure, and when you say it's not helping, is it bringing the temperature down at all? OK, alright. And can I just double check have you gotten any cough or cold or sore throat or anything like that? But which are you getting, other than the ones you've already mentioned to me? Sure. Have you have you had any ear pain ? OK, um, just, I just need to check for any other causes of infection in the body. So I'm gonna go through some, um, kind of systemic questions. Have you had any diarrhoea? OK. Have you got any neck stiffness at all? OK. Alright. Um, do you have any headache? OK. OK, so, you know your normal headache, where is that, in the back of your head or the front of the head? OK. and how long have you been having that for? OK. Um, have you got any rash on your body anywhere at all? Uh, any joints swollen or tender or sore? OK, alright. Alright, and, um, have you got any kind of symptoms down below when you're passing urine? OK. Any painful urination at all? Are you passing urine more often than normal? OK. Have you been abroad anywhere recently? Where have you been? OK. Uh, and, um, uh, did you take malaria preventative medication when you went out there? Which one did you take? Was it a weekly tablet or a daily tablet? OK, um, and was it one tablet or was it another one that you would take on top of the first one? OK. And, and what were you doing out in Vietnam? Was it just seeing the cities or going through villages or hiking? What what kind of activities were you doing? OK. Uh, and um, did you do any kind of, were you in rivers or things like that? Were you, you know, how adventurous were you? Where you going out into the rivers? Were you going on beaches? I mean how adventurous was your trip? Right, OK. Um, thank you for sharing that with me. Now, do you have, um, any other illnesses at all, in the past? And that back pain have you, um, have you seen anyone about that? Have they, have they give you any kind of diagnosis at all? Alright um, are there any illnesses in your family at all? I'm sorry to hear that. Um, how old was he when that happened? OK. Um, are you on any medication at all? OK. Uh, do you have any allergies at all? medication? OK, so hay fever. Alright. Um, are you, um, you're working at the moment? What do you work at? OK, all right. Um, and, um, you're up to date with all the vaccinations, Hepatitis B, and that kind of thing? OK. So, I can . Sure, OK. Um, and, are you a, uh, are you a smoker at all? OK, and ohh do you drink much alcohol? OK, and how much kind of physical exercise do you do normally? OK, that's good, alright, um, so, um What, uh, I think we're gonna need to do is we're gonna need to bring you into one of our clinics. Examine , and we're gonna need to arrange some blood tests as well. OK, um, so, what what I want to do is, the first question I have in my mind is that we need to find a reason for why you've got this fever and these symptoms, because there's no apparent reason from what you've told me. There's no, uh, when someone has got fever and sweats, we want to find out have they got chest infection, have they got a throat infection? Um, and if we can't find a focus of infection, then that's something, that, that's an outstanding question that needs to be answered, OK? Um, the second thing, second factor, is that you've recently come from, uh, Vietnam. And you've had exposure to rural areas. And we need to think about things like malaria or other exotic infections as well. So, um, you're probably gonna need some blood tests. After you've been seen by somebody. Um, now, the urgency of those blood tests depends partly on what we find when we examine you, which is why we're going to go, go for the examination first. You come into one of our clinics in central London, that's one option, and then the the GP there who examines you can then decide on how urgent the blood tests and things are going to be. Or, if it's inconvenient for you to come into central London because you you're living further out, you could actually just attend a local A and E. I'm going to type up what my thought process is and what kind of test I think you need in the notes for this appointment, so you could show that to them at reception. Um, I'll be asking for something called thick and thin blood films, to check for malaria. And inflammatory markers and things like those, technical terms, but they'll understand what that, what I'm talking about. But, um, I, I don't think you can go into work, uh, until we've sorted this out. And we, we, we need to sort this out sooner rather than later. OK. OK, fine, so what I'm going to do is I will send a message to one of our admin team members asking them to book you in. And if you can ring the number that I leave in your consultation notes, after a few minutes, and then they'll slot you in, and then we can sort things out from there. OK? Alright then, OK. Take care then. All the best. Bye.",
"patient_utterances": "Hello there! Hello there? Um, I'm wondering if you can help me today. Yes, it's Sarah Smith, and it's the second of November, um, nineteen ninety two. I am indeed, yes. OK. I, I've really not been feeling so well at all recently. I, I've been struggling with fever for the past week. Yeah, I would say it's about seven days ago. I'm just, I'm really hot and sweaty all the time, and just generally not feeling good. Um, I'd say that I'm aching all over really, my muscles are really aching. I'm feeling quite nauseous, uh, so I've not been able to eat very much, and I have been drinking but it's been quite a small amount. Um, and, yeah, just generally quite tired and unwell. I'm sweating during the the the night, I'm quite cold. Yes, yes, quite interchangeable, not really a pattern to it. Uh, I've been trying to, like, take ibuprofen and paracetamol just to from over the counter, but it's not really helping, just been taking the recommended dose every day of those. Perhaps slightly, yes, but I'm still experiencing these symptoms, so, it does take the edge off a bit. Mmm, not those sort of symptoms, really. Um Um, so, I have a habit that it's mainly just the sweating, really, and the and the nausea, uh, that's overtaking all all day and, uh, the aching muscles all over. Mmm, no, my ears are fine, actually. I haven't had any problems with my ears. And not, not really no, not that I can find. Um, no. My neck's, my neck's been fine. Not more than usual, no. Just like the, general headaches but not, just from staring at the screen. No migraines, or anything. Uum, it's quite centralized over, over the head. It's something that I've struggled with through, years really, just related to a screen use, or, uum, like changes in weather patterns. Yeah, high pressure days, sometimes I struggle with migraines, and headaches. Uh, I haven't noticed any rashes, no. Mmm, not really. I mean, I, I often have problems with back pain but not really any other joints. Any problems? Uh, no, there's been no problems there. Uh, not at all, no. Uh, I don't think so, no it's been fairly regular. Yes, I have actually. I went to Vietnam. Uh, I came back four weeks ago now. I did, yes. Ooo, I can't remember now, off the top of my head. I think it was daily. I think it was, uh another one that I took on top of the first one. It was quite really, 'cause we were there for a few weeks, and we toured to, uh, several different parts of the country, and uh, the countryside and some cities as well. I'm sorry, could you repeat that? I missed that. Yes, it was quite adventurous. We were sort of trekking and, um, cycling, uh, through the farmland and, um, seeing how people lived in a day-to-day life in, in, in farmland. Mmm, as I said I've, I've been struggling with back pain for quite a while, but I haven't really had any, uh, major illnesses in the past, I can think of. Yes, yeah, I'm under a physiotherapist at the moment for that. Um, they've said that it's, u,h related to long periods of time sitting at a desk, and just, uh, bad posture. So mainly the exercises are focused on improving posture and, and to strengthen the muscles in the back. Hmm, the main one would be, um, heart attack. My, my father passed away of that. in his sixties. Um, sixty eight, I think. Yeah. Uh, just Seroxat. No, I've just really pollen allergy. That's all I have. Yes, yeah, just hay fever. Uh, I am, yes. I work as a nurse. Yes, indeed. Yeah. But I'm, I'm really struggling quite a lot at work at the moment. It's been quite difficult, feeling so, uh, tired all the time. No, I'm not. Mmm, moderate alcohol intake. Yeah, I don't drink too much. I try and do, uh, some moderate physical exercise a few times a week. OK. OK. OK. OK. OK. That sounds great. Thank you so much for your help. I, I think, yeah, I can come straight into central London today to get that sorted. That's brilliant. Thank you very much. Goodbye.",
"num_turns": 118,
"reference_note": "{\"day\": 2, \"consultation\": 8, \"presenting_complaint\": \"I've been feeling very hot and sweaty for the past week\", \"note\": \"Hx of fever for a week with associated sweatiness, body/muscle aches, nausea, fatigue, night sweats, hot/cold episodes\\nDrinking less cf normal\\n Taking ibuprofen and paracetamol otc- not helping, helps with temp slightly\\nNo cough, sore throat, runny nose, ear pain.\\nNo diarrhea, no neck stiffness, no headache (no more than usual- normal headache on top of head through looking at screen). No rash, no joint swelling (ongoing back pain), no dysuria or frequency.\\nRecent foreign travel- returned from Vietnam, took malaria prevention daily- cant remember medication, present there for a few weeks, rural and urban tourism, trekking and cycling.\\nPmhx: nil of note, back pain- under physiotherapy, working diagnosis ? muscular/ posture\\nFh: father has MI at age 68\\nDH: on cerazette\\nNil allergies, hayfever\\nSH: works as a nurse, UTD with hep B etc, non smoker, moderate alcohol intake, moderate physical exercise\\nImp: PUO, need to exclude malaria\\nPlan: for f2f appointment with GP today\\nThereafter, for blood tests including crp, esr, thick and thin blood films (possibly routine, possibly via a/e- depending on second GP's assessment)\\n\", \"highlights\": [\"fever\", \"sweatiness\", \"muscle aches\", \"nausea\", \"fatigue\", \"night sweats\", \"Recent foreign travel\", \"cerazette\", \"Nil allergies\", \"hayfever\", \"nurse\", \"non smoker\", \"PUO\", \"need to exclude malaria\"]}",
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"dialogue": "[Doctor] Hello. Good afternoon.\n[Patient] Hiya.\n[Doctor] Hi there. This is Doctor , from GP at Hand.\n[Patient] Hi there. My name's Atan.\n[Doctor] Hi Anthony. So, could I have your um, before we start, could I have your full name and date of birth? If that's possible?\n[Patient] Sure. So, it's Ayrton Warren. Um, and my date of birth, is the sixteenth of May, nineteen, eighty two.\n[Doctor] That's , thank you for that. Are you in a private place where you're OK to speak?\n[Patient] I am, yes.\n[Doctor] OK, great. So how can I help you today?\n[Patient] Um, so I kind of woke up this morning, um, and I've just got this, really horrible pain on the left side of my head. Um, a real kind of headachy feeling.\n[Doctor] Sure, OK. And, um, uh, , did the, did the pain wake you up?\n[Patient] Yeah, it woke me up, um, quite early this morning.\n[Doctor] What, what time did it wake you up?\n[Patient] Um, probably around, five thirty ish.\n[Doctor] And, what time do you normally get up?\n[Patient] Um, I normally get up at about, seven o'clock.\n[Doctor] Is the headache still present now?\n[Patient] Yes, it is.\n[Doctor] OK. Have you had this kind of pain before?\n[Patient] Um, I mean uh, I've, had a bit of a history with headaches, but nothing as severe as this before.\n[Doctor] So they were less severe. Were they similar in nature in terms of being one-sided and the type of pain?\n[Patient] Um, not so much on the one side, it tends to be, a bit of a cluster at the front of my head in a way. Um, but this time it's just kind of more prominent on the left side which, I've never really had it, normally they kind of spread across the front of my head.\n[Doctor] OK, all right. And, um, can I just double-check, do you have any neck stiffness at all?\n[Patient] Uh, no.\n[Doctor] OK. And do you have any fever?\n[Patient] No.\n[Doctor] All right. Um, how are you with bright lights at the moment? Do you feel sensitive to bright lights or can you, can you tolerate them all right, OK?\n[Patient] Um, it, I'm a little bit sensitive it just, it kind of, makes my eyes a little bit sore, but nothing that I can't really handle.\n[Doctor] OK. And, can I just double-check, um, are you feeling nauseous at all?\n[Patient] Um, not really, like . When I first got up this morning, my head felt a bit dizzy, but that's kind of subsided now, and I, seems to, be fine.\n[Doctor] OK. Um, and um, can I just double-check, does anyone in your family have any migraines or anything like that? They've been diagnosed with migraines?\n[Patient] Uh, no. They haven't.\n[Doctor] OK. Um, and um, are you under any particular stress at the moment?\n[Patient] Um, work's kind of, um, a bit stressful at the moment. I've got a lot going on. Um, yeah, I just seem to have like, a lot of, kind of, a backlog of work that I need to go through at the moment. So, I've kind of, been, doing a lot of late nights as well.\n[Doctor] Right, OK. Um, and, um, how long has that been the case for?\n[Patient] Uh, for probably about a couple of months now.\n[Doctor] , how would you say your mood is?\n[Patient] Um, I'm not, like moody, I'm not angry or, um, like I get a bit frustrated during the day. Um, but , it kind of, um, ebbs and flows every now and then, but, yeah.\n[Doctor] OK. Do you have, have you ever been diagnosed with anxiety, or depression or stress in the past?\n[Patient] Um, I've had, um, so I had, like anxiety for about, two years now, and I've been on, uh, Sertraline for, a while.\n[Doctor] OK. Are you taking Sertraline at the moment?\n[Patient] Yes.\n[Doctor] OK. Um, and how do you feel in terms of , anxiety at the moment? Do you feel anxious at the moment?\n[Patient] , no, not necessarily at work, sometimes I do feel a bit anxious. Um, but I, I kind of just, uh, the panic of not being able to get my work done on time.\n[Doctor] \n[Patient] Um, but other than that, I, I don't, feel, um, massively anxious.\n[Doctor] OK, all right. Um, now, sorry to ask this, just need to ask this for , anyone suffering from anxiety. Do you have any , have you had any thoughts about harming yourself or hurting yourself?\n[Patient] No.\n[Doctor] Good, I'm glad to hear that. Um, now, with regards to this headache. Is it worse when you lie down, or um, is, is, is it better when you lie down?\n[Patient] Um, when I lay down, like, uh, it kind of feels a little bit sore at first, um and it takes me a while to get comfortable. Um, so yeah, at the beginning it does, but then again that's just kind of, um, soothes a little bit.\n[Doctor] OK. Um, so, would you say ultimately, it's better when you lie down? Or have you not ?\n[Patient] Uh, yeah, I would say so.\n[Doctor] OK. Um, and um, in terms of um, this, headache since this morning, have you taken anything for it yet?\n[Patient] Um, I've taken some Paracetamol.\n[Doctor] Has that helped?\n[Patient] Um, not really, no.\n[Doctor] OK. Taking anything else at all?\n[Patient] No that's it, just Paracetamol.\n[Doctor] OK. Um, do you have any other illnesses at all?\n[Patient] Uh, none.\n[Doctor] Have you ever been diagnosed with high blood pressure?\n[Patient] No.\n[Doctor] Have you ever had your blood pressure checked?\n[Patient] No.\n[Doctor] OK. Um, and are there any illnesses in your family?\n[Patient] Um, no, there's nothing. My parents, uh, my mum's had a history of anxiety as well but, no kind of like physical illnesses or anything like that.\n[Doctor] OK, all right. And um, are you on any medication?\n[Patient] Um, no, other, other than Sertraline and having taken, um, Paracetamol this morning, uh, nothing else.\n[Doctor] Do you have any allergies to any medication?\n[Patient] Not that I'm aware of, no.\n[Doctor] All right. And, are you living by yourself at the moment, or living with someone else?\n[Patient] Um, I live with my partner.\n[Doctor] OK. Are you a smoker?\n[Patient] No.\n[Doctor] OK. And, uh, do you have any pets at home?\n[Patient] Uh, I have a cat.\n[Doctor] OK. And, can I just double-check, how much exercise would you do normally a week?\n[Patient] Um, so normally I, try to go running at least three times a week.\n[Doctor] OK. And what's your diet like?\n[Patient] Um, it's OK, um, it's nothing, it's nothing um, really healthy, um, but it's fine.\n[Doctor] OK.\n[Patient] I wouldn't say unhealthy.\n[Doctor] All right. Um, now um, in terms of this headache, uh, obviously I haven't been able to examine you, or see you directly. But, um, it sounds like it might be one of two things. It could be an element of what we call tension headache.\n[Patient] Sure.\n[Doctor] OK. That's one possibility. Um, and what makes that, more likely is the fact that, you've been under some pressure, and you have a history of anxiety in the past, OK. Um.\n[Patient] OK.\n[Doctor] The other possibility is, um, migraine as well. OK. Um, and, the fact, what makes that more likely is the fact that it's on one side, and that you've got some sensitivity to light.\n[Patient] OK.\n[Doctor] OK, So, what, what I think we can do, is um, I think we can give you some, um, generic, pain relief.\n[Patient] OK.\n[Doctor] That would be the appropriate first step, for, migraine type headaches. OK. So I'll tell you what it is in a second.\n[Patient] OK.\n[Doctor] And the other thing that I was gonna suggest is, we maybe look, explore things to try and decrease the stress from work. So, um, the medication-wise, the things that we'd start off first line, if someone had migraine was to, would be to start Ibuprofen.\n[Patient] OK.\n[Doctor] And um, uh, that, the doses of Ibuprofen can be a bit, more than the normal doses Ibuprofen so that's one thing we can start. You can keep on taking Paracetamol as well if you like, but the, the Ibuprofen's um, actually more effective , for migraine.\n[Patient] OK.\n[Doctor] And, um, yeah, so the, the guidelines have changed, recently we used, we, before that we used to give Paracetamol as first line but now it's, um, Ibuprofen or Aspirin.\n[Patient] Ohh right, O.\n[Doctor] That's, thing. Um, the other thing I'd like you to do, is maybe consider taking some time off work. OK, because if the headache is due to stress from work.\n[Patient] OK.\n[Patient] OK.\n[Doctor] Um, maybe having a week off if you self-certify, that might help with things. And I'd also like you to explore, counselling options as well so there's, a counselling service in your area, that I can give you the link for, for you to self-refer.\n[Patient] \n[Doctor] I'd like you to, , OK I'd like you to try that. Um, what, we're gonna do is, we'll have a follow-up in a week's time.\n[Patient] Yeah, that'd be.\n[Doctor] As well as those two things, other things I'd like you to do, is to try and ensure that you're having a minimum of seven, eight hours sleep at night, every night. And you're drinking a minimum of, um, one point five to two litres uh, of water or fluids a day, and that's not including coffee or tea.\n[Patient] OK.\n[Patient] OK.\n[Doctor] All right, because sometimes dehydration and you know uh, fatigue can be causes of headaches as well. Um.\n[Patient] Ohh OK, I didn't realise that.\n[Doctor] Yeah, so it, that, that, that is um, you know, we need to rule those things out. Um, let's, let's try that. OK. Um, and let's have a follow-up appointment, if we're finding that things are not getting better, we might need to arrange some blood tests or um, look at uh, other possibilities, but, we'll try that in the first instance. Um, if anything changes in the meantime, or you get worried or things get worse. Feel free, have a lower threshold for ringing us back and we can book you an appointment, and we can reassess the situation.\n[Patient] OK. Yeah, the, that, that sounds brilliant. Thank you so much for your help.\n[Doctor] OK, no problem. So there'll be a summary of all of this in the notes. Um, and I'll also leave a link, to some of the danger signs of symptoms of headaches, in the notes. If you can read through that in your own time, that will just help you to have a bit more, control over what's going on and understanding of what, what, what kind of things, should trigger you contacting another doctor.\n[Patient] OK. That's perfect. Thank you so much for your help.\n[Doctor] No problem, OK. So we'll, we'll touch base in a week's time, with me or, myself or one of the other doctors, and we , we'll take it from there, OK.\n[Patient] OK. Thank you. Yeah, I'll book an appointment, in, um, yeah, in that time.\n[Doctor] Brilliant, OK then, all right. Take care then, all the best.\n[Patient] Bye. Thank you, and you.\n[Doctor] Bye bye.\n[Patient] Bye.",
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{
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"text": "Hello. Good afternoon.",
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"text": "Hiya.",
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"text": "Hi there. This is Doctor , from GP at Hand.",
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"text": "Hi there. My name's Atan.",
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"text": "Hi Anthony. So, could I have your um, before we start, could I have your full name and date of birth? If that's possible?",
"speaker": "Doctor"
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"text": "Sure. So, it's Ayrton Warren. Um, and my date of birth, is the sixteenth of May, nineteen, eighty two.",
"speaker": "Patient"
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"text": "That's , thank you for that. Are you in a private place where you're OK to speak?",
"speaker": "Doctor"
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"text": "I am, yes.",
"speaker": "Patient"
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"text": "OK, great. So how can I help you today?",
"speaker": "Doctor"
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{
"start": 33.24442,
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"text": "Um, so I kind of woke up this morning, um, and I've just got this, really horrible pain on the left side of my head. Um, a real kind of headachy feeling.",
"speaker": "Patient"
},
{
"start": 42.41738,
"end": 48.13263,
"text": "Sure, OK. And, um, uh, , did the, did the pain wake you up?",
"speaker": "Doctor"
},
{
"start": 48.53928,
"end": 51.58243,
"text": "Yeah, it woke me up, um, quite early this morning.",
"speaker": "Patient"
},
{
"start": 51.43728,
"end": 52.86112,
"text": "What, what time did it wake you up?",
"speaker": "Doctor"
},
{
"start": 53.21116,
"end": 57.05003,
"text": "Um, probably around, five thirty ish.",
"speaker": "Patient"
},
{
"start": 57.22538,
"end": 58.83465,
"text": "And, what time do you normally get up?",
"speaker": "Doctor"
},
{
"start": 59.22987,
"end": 62.02842,
"text": "Um, I normally get up at about, seven o'clock.",
"speaker": "Patient"
},
{
"start": 63.17241,
"end": 64.92739,
"text": "Is the headache still present now?",
"speaker": "Doctor"
},
{
"start": 65.22984,
"end": 66.31617,
"text": "Yes, it is.",
"speaker": "Patient"
},
{
"start": 67.00024,
"end": 69.58965,
"text": "OK. Have you had this kind of pain before?",
"speaker": "Doctor"
},
{
"start": 69.66148,
"end": 75.7118,
"text": "Um, I mean uh, I've, had a bit of a history with headaches, but nothing as severe as this before.",
"speaker": "Patient"
},
{
"start": 76.48372,
"end": 82.22546,
"text": "So they were less severe. Were they similar in nature in terms of being one-sided and the type of pain?",
"speaker": "Doctor"
},
{
"start": 82.23694,
"end": 95.94187,
"text": "Um, not so much on the one side, it tends to be, a bit of a cluster at the front of my head in a way. Um, but this time it's just kind of more prominent on the left side which, I've never really had it, normally they kind of spread across the front of my head.",
"speaker": "Patient"
},
{
"start": 96.40433,
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"text": "OK, all right. And, um, can I just double-check, do you have any neck stiffness at all?",
"speaker": "Doctor"
},
{
"start": 102.09291,
"end": 103.09291,
"text": "Uh, no.",
"speaker": "Patient"
},
{
"start": 103.66264,
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"text": "OK. And do you have any fever?",
"speaker": "Doctor"
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{
"start": 106.53894,
"end": 107.28893,
"text": "No.",
"speaker": "Patient"
},
{
"start": 107.78185,
"end": 114.27857,
"text": "All right. Um, how are you with bright lights at the moment? Do you feel sensitive to bright lights or can you, can you tolerate them all right, OK?",
"speaker": "Doctor"
},
{
"start": 113.7907,
"end": 120.81943,
"text": "Um, it, I'm a little bit sensitive it just, it kind of, makes my eyes a little bit sore, but nothing that I can't really handle.",
"speaker": "Patient"
},
{
"start": 120.78853,
"end": 125.35146,
"text": "OK. And, can I just double-check, um, are you feeling nauseous at all?",
"speaker": "Doctor"
},
{
"start": 125.48846,
"end": 134.45962,
"text": "Um, not really, like . When I first got up this morning, my head felt a bit dizzy, but that's kind of subsided now, and I, seems to, be fine.",
"speaker": "Patient"
},
{
"start": 134.81507,
"end": 142.38464,
"text": "OK. Um, and um, can I just double-check, does anyone in your family have any migraines or anything like that? They've been diagnosed with migraines?",
"speaker": "Doctor"
},
{
"start": 142.23655,
"end": 143.94158,
"text": "Uh, no. They haven't.",
"speaker": "Patient"
},
{
"start": 143.9012,
"end": 149.61645,
"text": "OK. Um, and um, are you under any particular stress at the moment?",
"speaker": "Doctor"
},
{
"start": 149.93435,
"end": 164.3138,
"text": "Um, work's kind of, um, a bit stressful at the moment. I've got a lot going on. Um, yeah, I just seem to have like, a lot of, kind of, a backlog of work that I need to go through at the moment. So, I've kind of, been, doing a lot of late nights as well.",
"speaker": "Patient"
},
{
"start": 164.35162,
"end": 169.33839,
"text": "Right, OK. Um, and, um, how long has that been the case for?",
"speaker": "Doctor"
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{
"start": 169.73522,
"end": 172.57448,
"text": "Uh, for probably about a couple of months now.",
"speaker": "Patient"
},
{
"start": 174.4314,
"end": 177.00729,
"text": ", how would you say your mood is?",
"speaker": "Doctor"
},
{
"start": 177.84783,
"end": 191.03949,
"text": "Um, I'm not, like moody, I'm not angry or, um, like I get a bit frustrated during the day. Um, but , it kind of, um, ebbs and flows every now and then, but, yeah.",
"speaker": "Patient"
},
{
"start": 191.00073,
"end": 196.79546,
"text": "OK. Do you have, have you ever been diagnosed with anxiety, or depression or stress in the past?",
"speaker": "Doctor"
},
{
"start": 196.65346,
"end": 205.19297,
"text": "Um, I've had, um, so I had, like anxiety for about, two years now, and I've been on, uh, Sertraline for, a while.",
"speaker": "Patient"
},
{
"start": 205.7955,
"end": 208.42464,
"text": "OK. Are you taking Sertraline at the moment?",
"speaker": "Doctor"
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{
"start": 208.58144,
"end": 209.34297,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 210.12663,
"end": 216.50414,
"text": "OK. Um, and how do you feel in terms of , anxiety at the moment? Do you feel anxious at the moment?",
"speaker": "Doctor"
},
{
"start": 215.31521,
"end": 226.20814,
"text": ", no, not necessarily at work, sometimes I do feel a bit anxious. Um, but I, I kind of just, uh, the panic of not being able to get my work done on time.",
"speaker": "Patient"
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{
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"end": 226.62339,
"text": "",
"speaker": "Doctor"
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{
"start": 226.20814,
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"text": "Um, but other than that, I, I don't, feel, um, massively anxious.",
"speaker": "Patient"
},
{
"start": 232.12672,
"end": 240.12013,
"text": "OK, all right. Um, now, sorry to ask this, just need to ask this for , anyone suffering from anxiety. Do you have any , have you had any thoughts about harming yourself or hurting yourself?",
"speaker": "Doctor"
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{
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"text": "No.",
"speaker": "Patient"
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{
"start": 242.36517,
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"text": "Good, I'm glad to hear that. Um, now, with regards to this headache. Is it worse when you lie down, or um, is, is, is it better when you lie down?",
"speaker": "Doctor"
},
{
"start": 250.0012,
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"text": "Um, when I lay down, like, uh, it kind of feels a little bit sore at first, um and it takes me a while to get comfortable. Um, so yeah, at the beginning it does, but then again that's just kind of, um, soothes a little bit.",
"speaker": "Patient"
},
{
"start": 263.47145,
"end": 271.13806,
"text": "OK. Um, so, would you say ultimately, it's better when you lie down? Or have you not ?",
"speaker": "Doctor"
},
{
"start": 270.14052,
"end": 273.01858,
"text": "Uh, yeah, I would say so.",
"speaker": "Patient"
},
{
"start": 273.79817,
"end": 282.62817,
"text": "OK. Um, and um, in terms of um, this, headache since this morning, have you taken anything for it yet?",
"speaker": "Doctor"
},
{
"start": 282.99976,
"end": 285.35071,
"text": "Um, I've taken some Paracetamol.",
"speaker": "Patient"
},
{
"start": 285.79809,
"end": 287.13796,
"text": "Has that helped?",
"speaker": "Doctor"
},
{
"start": 287.4465,
"end": 289.09171,
"text": "Um, not really, no.",
"speaker": "Patient"
},
{
"start": 289.8765,
"end": 292.23597,
"text": "OK. Taking anything else at all?",
"speaker": "Doctor"
},
{
"start": 292.5447,
"end": 294.8183,
"text": "No that's it, just Paracetamol.",
"speaker": "Patient"
},
{
"start": 294.62158,
"end": 297.83071,
"text": "OK. Um, do you have any other illnesses at all?",
"speaker": "Doctor"
},
{
"start": 298.3921,
"end": 299.30749,
"text": "Uh, none.",
"speaker": "Patient"
},
{
"start": 299.95488,
"end": 302.35356,
"text": "Have you ever been diagnosed with high blood pressure?",
"speaker": "Doctor"
},
{
"start": 302.43697,
"end": 303.22927,
"text": "No.",
"speaker": "Patient"
},
{
"start": 303.75879,
"end": 306.03982,
"text": "Have you ever had your blood pressure checked?",
"speaker": "Doctor"
},
{
"start": 305.89019,
"end": 306.62096,
"text": "No.",
"speaker": "Patient"
},
{
"start": 307.86335,
"end": 311.83064,
"text": "OK. Um, and are there any illnesses in your family?",
"speaker": "Doctor"
},
{
"start": 312.34046,
"end": 321.2642,
"text": "Um, no, there's nothing. My parents, uh, my mum's had a history of anxiety as well but, no kind of like physical illnesses or anything like that.",
"speaker": "Patient"
},
{
"start": 321.40573,
"end": 325.34689,
"text": "OK, all right. And um, are you on any medication?",
"speaker": "Doctor"
},
{
"start": 325.70302,
"end": 332.80369,
"text": "Um, no, other, other than Sertraline and having taken, um, Paracetamol this morning, uh, nothing else.",
"speaker": "Patient"
},
{
"start": 333.18343,
"end": 335.35989,
"text": "Do you have any allergies to any medication?",
"speaker": "Doctor"
},
{
"start": 335.54468,
"end": 337.30727,
"text": "Not that I'm aware of, no.",
"speaker": "Patient"
},
{
"start": 337.28799,
"end": 341.15071,
"text": "All right. And, are you living by yourself at the moment, or living with someone else?",
"speaker": "Doctor"
},
{
"start": 341.3576,
"end": 343.20226,
"text": "Um, I live with my partner.",
"speaker": "Patient"
},
{
"start": 343.65396,
"end": 345.88271,
"text": "OK. Are you a smoker?",
"speaker": "Doctor"
},
{
"start": 345.94751,
"end": 346.94751,
"text": "No.",
"speaker": "Patient"
},
{
"start": 347.47094,
"end": 350.30099,
"text": "OK. And, uh, do you have any pets at home?",
"speaker": "Doctor"
},
{
"start": 350.40793,
"end": 351.91152,
"text": "Uh, I have a cat.",
"speaker": "Patient"
},
{
"start": 352.49052,
"end": 356.60161,
"text": "OK. And, can I just double-check, how much exercise would you do normally a week?",
"speaker": "Doctor"
},
{
"start": 356.76689,
"end": 360.61152,
"text": "Um, so normally I, try to go running at least three times a week.",
"speaker": "Patient"
},
{
"start": 361.15714,
"end": 364.52313,
"text": "OK. And what's your diet like?",
"speaker": "Doctor"
},
{
"start": 364.85389,
"end": 371.46928,
"text": "Um, it's OK, um, it's nothing, it's nothing um, really healthy, um, but it's fine.",
"speaker": "Patient"
},
{
"start": 372.1636,
"end": 373.07209,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 372.44424,
"end": 374.05526,
"text": "I wouldn't say unhealthy.",
"speaker": "Patient"
},
{
"start": 374.28124,
"end": 388.09159,
"text": "All right. Um, now um, in terms of this headache, uh, obviously I haven't been able to examine you, or see you directly. But, um, it sounds like it might be one of two things. It could be an element of what we call tension headache.",
"speaker": "Doctor"
},
{
"start": 382.63794,
"end": 383.36871,
"text": "Sure.",
"speaker": "Patient"
},
{
"start": 388.09159,
"end": 397.68539,
"text": "OK. That's one possibility. Um, and what makes that, more likely is the fact that, you've been under some pressure, and you have a history of anxiety in the past, OK. Um.",
"speaker": "Doctor"
},
{
"start": 388.26636,
"end": 389.00482,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 397.68539,
"end": 408.55949,
"text": "The other possibility is, um, migraine as well. OK. Um, and, the fact, what makes that more likely is the fact that it's on one side, and that you've got some sensitivity to light.",
"speaker": "Doctor"
},
{
"start": 401.32106,
"end": 402.14142,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 408.55949,
"end": 416.56196,
"text": "OK, So, what, what I think we can do, is um, I think we can give you some, um, generic, pain relief.",
"speaker": "Doctor"
},
{
"start": 408.70973,
"end": 409.50972,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 416.56196,
"end": 423.65864,
"text": "That would be the appropriate first step, for, migraine type headaches. OK. So I'll tell you what it is in a second.",
"speaker": "Doctor"
},
{
"start": 421.97583,
"end": 422.97583,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 423.65864,
"end": 439.17351,
"text": "And the other thing that I was gonna suggest is, we maybe look, explore things to try and decrease the stress from work. So, um, the medication-wise, the things that we'd start off first line, if someone had migraine was to, would be to start Ibuprofen.",
"speaker": "Doctor"
},
{
"start": 430.46498,
"end": 431.46498,
"text": "OK.",
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"text": "And um, uh, that, the doses of Ibuprofen can be a bit, more than the normal doses Ibuprofen so that's one thing we can start. You can keep on taking Paracetamol as well if you like, but the, the Ibuprofen's um, actually more effective , for migraine.",
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"text": "And, um, yeah, so the, the guidelines have changed, recently we used, we, before that we used to give Paracetamol as first line but now it's, um, Ibuprofen or Aspirin.",
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"text": "That's, thing. Um, the other thing I'd like you to do, is maybe consider taking some time off work. OK, because if the headache is due to stress from work.",
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"text": "Um, maybe having a week off if you self-certify, that might help with things. And I'd also like you to explore, counselling options as well so there's, a counselling service in your area, that I can give you the link for, for you to self-refer.",
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"text": "I'd like you to, , OK I'd like you to try that. Um, what, we're gonna do is, we'll have a follow-up in a week's time.",
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"text": "Yeah, that'd be.",
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"text": "As well as those two things, other things I'd like you to do, is to try and ensure that you're having a minimum of seven, eight hours sleep at night, every night. And you're drinking a minimum of, um, one point five to two litres uh, of water or fluids a day, and that's not including coffee or tea.",
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"text": "OK.",
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"text": "OK.",
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"text": "All right, because sometimes dehydration and you know uh, fatigue can be causes of headaches as well. Um.",
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"text": "Ohh OK, I didn't realise that.",
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"text": "Yeah, so it, that, that, that is um, you know, we need to rule those things out. Um, let's, let's try that. OK. Um, and let's have a follow-up appointment, if we're finding that things are not getting better, we might need to arrange some blood tests or um, look at uh, other possibilities, but, we'll try that in the first instance. Um, if anything changes in the meantime, or you get worried or things get worse. Feel free, have a lower threshold for ringing us back and we can book you an appointment, and we can reassess the situation.",
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"text": "OK. Yeah, the, that, that sounds brilliant. Thank you so much for your help.",
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"text": "OK, no problem. So there'll be a summary of all of this in the notes. Um, and I'll also leave a link, to some of the danger signs of symptoms of headaches, in the notes. If you can read through that in your own time, that will just help you to have a bit more, control over what's going on and understanding of what, what, what kind of things, should trigger you contacting another doctor.",
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"text": "OK. That's perfect. Thank you so much for your help.",
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"text": "No problem, OK. So we'll, we'll touch base in a week's time, with me or, myself or one of the other doctors, and we , we'll take it from there, OK.",
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"text": "OK. Thank you. Yeah, I'll book an appointment, in, um, yeah, in that time.",
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"text": "Brilliant, OK then, all right. Take care then, all the best.",
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"doctor_utterances": "Hello. Good afternoon. Hi there. This is Doctor , from GP at Hand. Hi Anthony. So, could I have your um, before we start, could I have your full name and date of birth? If that's possible? That's , thank you for that. Are you in a private place where you're OK to speak? OK, great. So how can I help you today? Sure, OK. And, um, uh, , did the, did the pain wake you up? What, what time did it wake you up? And, what time do you normally get up? Is the headache still present now? OK. Have you had this kind of pain before? So they were less severe. Were they similar in nature in terms of being one-sided and the type of pain? OK, all right. And, um, can I just double-check, do you have any neck stiffness at all? OK. And do you have any fever? All right. Um, how are you with bright lights at the moment? Do you feel sensitive to bright lights or can you, can you tolerate them all right, OK? OK. And, can I just double-check, um, are you feeling nauseous at all? OK. Um, and um, can I just double-check, does anyone in your family have any migraines or anything like that? They've been diagnosed with migraines? OK. Um, and um, are you under any particular stress at the moment? Right, OK. Um, and, um, how long has that been the case for? , how would you say your mood is? OK. Do you have, have you ever been diagnosed with anxiety, or depression or stress in the past? OK. Are you taking Sertraline at the moment? OK. Um, and how do you feel in terms of , anxiety at the moment? Do you feel anxious at the moment? OK, all right. Um, now, sorry to ask this, just need to ask this for , anyone suffering from anxiety. Do you have any , have you had any thoughts about harming yourself or hurting yourself? Good, I'm glad to hear that. Um, now, with regards to this headache. Is it worse when you lie down, or um, is, is, is it better when you lie down? OK. Um, so, would you say ultimately, it's better when you lie down? Or have you not ? OK. Um, and um, in terms of um, this, headache since this morning, have you taken anything for it yet? Has that helped? OK. Taking anything else at all? OK. Um, do you have any other illnesses at all? Have you ever been diagnosed with high blood pressure? Have you ever had your blood pressure checked? OK. Um, and are there any illnesses in your family? OK, all right. And um, are you on any medication? Do you have any allergies to any medication? All right. And, are you living by yourself at the moment, or living with someone else? OK. Are you a smoker? OK. And, uh, do you have any pets at home? OK. And, can I just double-check, how much exercise would you do normally a week? OK. And what's your diet like? OK. All right. Um, now um, in terms of this headache, uh, obviously I haven't been able to examine you, or see you directly. But, um, it sounds like it might be one of two things. It could be an element of what we call tension headache. OK. That's one possibility. Um, and what makes that, more likely is the fact that, you've been under some pressure, and you have a history of anxiety in the past, OK. Um. The other possibility is, um, migraine as well. OK. Um, and, the fact, what makes that more likely is the fact that it's on one side, and that you've got some sensitivity to light. OK, So, what, what I think we can do, is um, I think we can give you some, um, generic, pain relief. That would be the appropriate first step, for, migraine type headaches. OK. So I'll tell you what it is in a second. And the other thing that I was gonna suggest is, we maybe look, explore things to try and decrease the stress from work. So, um, the medication-wise, the things that we'd start off first line, if someone had migraine was to, would be to start Ibuprofen. And um, uh, that, the doses of Ibuprofen can be a bit, more than the normal doses Ibuprofen so that's one thing we can start. You can keep on taking Paracetamol as well if you like, but the, the Ibuprofen's um, actually more effective , for migraine. And, um, yeah, so the, the guidelines have changed, recently we used, we, before that we used to give Paracetamol as first line but now it's, um, Ibuprofen or Aspirin. That's, thing. Um, the other thing I'd like you to do, is maybe consider taking some time off work. OK, because if the headache is due to stress from work. Um, maybe having a week off if you self-certify, that might help with things. And I'd also like you to explore, counselling options as well so there's, a counselling service in your area, that I can give you the link for, for you to self-refer. I'd like you to, , OK I'd like you to try that. Um, what, we're gonna do is, we'll have a follow-up in a week's time. As well as those two things, other things I'd like you to do, is to try and ensure that you're having a minimum of seven, eight hours sleep at night, every night. And you're drinking a minimum of, um, one point five to two litres uh, of water or fluids a day, and that's not including coffee or tea. All right, because sometimes dehydration and you know uh, fatigue can be causes of headaches as well. Um. Yeah, so it, that, that, that is um, you know, we need to rule those things out. Um, let's, let's try that. OK. Um, and let's have a follow-up appointment, if we're finding that things are not getting better, we might need to arrange some blood tests or um, look at uh, other possibilities, but, we'll try that in the first instance. Um, if anything changes in the meantime, or you get worried or things get worse. Feel free, have a lower threshold for ringing us back and we can book you an appointment, and we can reassess the situation. OK, no problem. So there'll be a summary of all of this in the notes. Um, and I'll also leave a link, to some of the danger signs of symptoms of headaches, in the notes. If you can read through that in your own time, that will just help you to have a bit more, control over what's going on and understanding of what, what, what kind of things, should trigger you contacting another doctor. No problem, OK. So we'll, we'll touch base in a week's time, with me or, myself or one of the other doctors, and we , we'll take it from there, OK. Brilliant, OK then, all right. Take care then, all the best. Bye bye.",
"patient_utterances": "Hiya. Hi there. My name's Atan. Sure. So, it's Ayrton Warren. Um, and my date of birth, is the sixteenth of May, nineteen, eighty two. I am, yes. Um, so I kind of woke up this morning, um, and I've just got this, really horrible pain on the left side of my head. Um, a real kind of headachy feeling. Yeah, it woke me up, um, quite early this morning. Um, probably around, five thirty ish. Um, I normally get up at about, seven o'clock. Yes, it is. Um, I mean uh, I've, had a bit of a history with headaches, but nothing as severe as this before. Um, not so much on the one side, it tends to be, a bit of a cluster at the front of my head in a way. Um, but this time it's just kind of more prominent on the left side which, I've never really had it, normally they kind of spread across the front of my head. Uh, no. No. Um, it, I'm a little bit sensitive it just, it kind of, makes my eyes a little bit sore, but nothing that I can't really handle. Um, not really, like . When I first got up this morning, my head felt a bit dizzy, but that's kind of subsided now, and I, seems to, be fine. Uh, no. They haven't. Um, work's kind of, um, a bit stressful at the moment. I've got a lot going on. Um, yeah, I just seem to have like, a lot of, kind of, a backlog of work that I need to go through at the moment. So, I've kind of, been, doing a lot of late nights as well. Uh, for probably about a couple of months now. Um, I'm not, like moody, I'm not angry or, um, like I get a bit frustrated during the day. Um, but , it kind of, um, ebbs and flows every now and then, but, yeah. Um, I've had, um, so I had, like anxiety for about, two years now, and I've been on, uh, Sertraline for, a while. Yes. , no, not necessarily at work, sometimes I do feel a bit anxious. Um, but I, I kind of just, uh, the panic of not being able to get my work done on time. Um, but other than that, I, I don't, feel, um, massively anxious. No. Um, when I lay down, like, uh, it kind of feels a little bit sore at first, um and it takes me a while to get comfortable. Um, so yeah, at the beginning it does, but then again that's just kind of, um, soothes a little bit. Uh, yeah, I would say so. Um, I've taken some Paracetamol. Um, not really, no. No that's it, just Paracetamol. Uh, none. No. No. Um, no, there's nothing. My parents, uh, my mum's had a history of anxiety as well but, no kind of like physical illnesses or anything like that. Um, no, other, other than Sertraline and having taken, um, Paracetamol this morning, uh, nothing else. Not that I'm aware of, no. Um, I live with my partner. No. Uh, I have a cat. Um, so normally I, try to go running at least three times a week. Um, it's OK, um, it's nothing, it's nothing um, really healthy, um, but it's fine. I wouldn't say unhealthy. Sure. OK. OK. OK. OK. OK. OK. Ohh right, O. OK. OK. Yeah, that'd be. OK. OK. Ohh OK, I didn't realise that. OK. Yeah, the, that, that sounds brilliant. Thank you so much for your help. OK. That's perfect. Thank you so much for your help. OK. Thank you. Yeah, I'll book an appointment, in, um, yeah, in that time. Bye. Thank you, and you. Bye.",
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"reference_note": "{\"day\": 2, \"consultation\": 10, \"presenting_complaint\": \"I've got a really bad headache\", \"note\": \"Hx: Has had headache upon waking from this morning on left side head- pain woke pt up at 530am\\nHeadache still present now\\n Has had hx of headaches less severe and in front of the head in past\\nNo neck stiffness, no fever\\nSome sensitivity to bright lights now, no nausea now\\nFelt dizzy this morning, but not now\\nNo FH of migraines\\nWork is stressful, late nights at work- ongoing for a few months. Mood is stable- pmhx of anxiety for 2 years, on sertraline. Doesn't feel anxious right now- gets this at work at times\\nNo thoughts about self harm\\nHeadache is better when lying down. \\nPt has taken paracetamol- not helped\\nPmhx: nil, has not had BP checked\\nFH: mother has anxiety\\nDH: sertraline\\nNkda\\nSH: live with partner\\nNon smoker\\nHss cat\\nGood exercise, reasonable diet\\nImp: tension type headache +/- migraine\\nPlan: for ibuprofen first line as per SIGN 2018 migraine guidelines\\n1.5-2 litres water hydration daily\\n To sleep 7-8 hours minimum daily\\nConsider time off- to self certify for a few days to see if this helps\\nSelf referral to IAPTs\\nReview in a week\\nIf any red flag symptoms as per www.patient.co.uk/ headache, to ring back sooner\\nPatient understands and is happy with plan\\n\", \"highlights\": [\"headache\", \"left side head\", \"Some sensitivity to bright lights\", \"anxiety\", \"on sertraline\", \"tension type headache\", \"ibuprofen\"]}",
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"dialogue": "[Doctor] Hi. Hello.\n[Patient] Hi, hi I'm Maria.\n[Doctor] Hello, I'm Doctor Jacob and welcome to Babylon.\n[Patient] \n[Doctor] How are you doing?\n[Patient] I'm all right, thank you. Well I feel a little weird today, to be honest.\n[Doctor] Yeah, so just before we we start, is it all right if you could confirm your full name for me please?\n[Patient] Yes. Maria Trabalotsa.\n[Doctor] OK, day and your date of birth?\n[Patient] That is the first of October, ninety-nine.\n[Doctor] OK, and your email address for me please?\n[Patient] Yes, M Traba at Gmail dot com.\n[Doctor] \n[Doctor] OK, and just to confirm that you're in a secure location and we can have a confidential conversation?\n[Patient] Yes I think I am, yeah.\n[Doctor] Good, right, you've mentioned in in, in your patient notes that you're having some sort of lip swelling, and you after you had a sandwich. Is that correct?\n[Patient] Yeah that is, well, I don't think, I don't think it was, it it wasn't a sandwich but it was, it was something with prawn so. Basically, I, I sometimes go with my friends to, to this place called . And, we, we regularly have like usually I have like a normal vegetarian soup or something.\n[Doctor] Mm-hmm.\n[Patient] And yeah, and, then I wanted to try something new.\n[Doctor] Mm-hmm.\n[Patient] Um, so what happened was, I, I ordered a prawn soup it it's it it's called it's like a soup, I ordered a prawn one this time.\n[Doctor] Yeah.\n[Patient] And, yeah and then my feel like my lips started feeling a little weird just in the in the corner sort of on the left first.\n[Doctor] Mm-hmm.\n[Patient] And then, I don't know and then, we went back we had little bit of chat, of banter I wasn't really, paying attention.\n[Doctor] \n[Patient] Uh, now I feel the that there is a swelling, there is like a swelling on my, on my upper lip and it's kind of getting bigger. I don't know what to do.\n[Doctor] Yeah.\n[Doctor] Right. All right. So when did you have the prawn soup? What time?\n[Patient] That was, that must have been just after work, so maybe like around seven.\n[Doctor] OK, around seven o'clock, and um how long did it take to develop the swelling?\n[Patient] Well I wasn't really paying attention so, it must have been like, must have been like, I don't know half an hour maybe.\n[Doctor] OK in half an hour you developed the swelling yeah?\n[Patient] Yeah.\n[Doctor] OK, and it's getting bigger and bigger?\n[Patient] Yeah it's it it still feel it like, really pumping blood and it's kinda getting bigger it feels like it's getting worse.\n[Doctor] OK. So, just a few more questions. Um, so you mentioned about your swelling of your lips. Is there any feeling of swelling in in your throat, like your throat is closing up, any feeling like that?\n[Patient] Yeah actually, I, I feel like I can't breathe that well right now.\n[Doctor] OK. And do you feel like, like your chest is tight?\n[Patient] And I don't know if it's the chest it just generally feels a little difficult, but yeah it might be, I'm not sure.\n[Doctor] OK.\n[Doctor] OK, right. And just a few have you ever these any kind of lip swelling in the past? After eating any food?\n[Patient] Yeah, well, maybe, I remember like a year ago. A year ago I was, out with my friends.\n[Doctor] Mm-hmm.\n[Patient] And I think we went like, to a late night kinda Chinese place, and I remember that I was quite drunk to be honest.\n[Doctor] Sure, OK.\n[Patient] And I remember that after like having that very late. I've woke up the next morning quite swollen up and had also I, felt really bad and quite difficult breathing, but I don't know what it was I had it was like a curry or something I think.\n[Doctor] OK.\n[Doctor] Right.\n[Doctor] OK. Uh, and what did you take at that time? Did you use anything like antihistamine or anything, when you had that last time?\n[Patient] But I generally have asthma so, I took I, I take, ohh what's it called? Salbutamol inhalers?\n[Doctor] Yeah.\n[Patient] Yeah, so I do take that regularly but I've always taken it. I generally have asthma.\n[Doctor] And any other inhalers? Is it just the Salbutamol that you use? Any other brown inhalers?\n[Patient] Ohh I, no I don't think so, no.\n[Doctor] OK right and um so, do you use antihistamines like Cetirizine, Loratadine, Piriton, any of those, kind of things?\n[Patient] Hmm, no. I, I got no I do sometimes but I don't know which ones, but I have a peanut allergy as well, like always had it.\n[Doctor] Yeah.\n[Doctor] Yeah.\n[Patient] I, think I do get antihistamines for that but I'm not sure which ones.\n[Doctor] And any point because you had peanut allergy, any time you have to ever use like an injection?\n[Patient] When I was a kid I think I remember my mom told me about it, but I don't know what it was 'cause I was small and I've changed doctors since.\n[Doctor] Right, so has your mum ever said that you had to go to hospital because you had an severe allergic reaction?\n[Patient] Yeah is that well I was like six or something I, I, I think. Ohh sorry, the swelling is getting, ohh my god ohh, yeah I think when I was six.\n[Doctor] Oh.\n[Doctor] You all right? Are you OK now?\n[Patient] Ohh, I feel a little dizzy right now to be honest, ohh.\n[Doctor] Are you .\n[Doctor] You're feeling dizzy. OK, right do you have any kind of, uh, antihistamines with you at the moment?\n[Patient] No, I don't think I have no.\n[Doctor] OK, right OK, so.\n[Patient] \n[Doctor] Right, uh, all right I, I'm really a bit worried about you at the moment, Maria. Um I think we need to call an ambulance, because, um, from what history you've been telling me. It sounds like you could be going into what we say an a, an anaphylactic reaction. That's when your throat and your chest, you know closes in and you might need an injection like what your mum's. Um, you know what your mum told you as you were a young child. OK, all right so is there any, anyone with you at the moment or are you alone?\n[Patient] \n[Patient] I'm alone at the moment, yeah.\n[Doctor] Ohh no so hang on the line, while I'll call the ambulance OK, and I'll send them right to you, OK and .\n[Patient] Hey ohh somebody just came, somebody just came yes, I'm not alone any more. Thank.\n[Doctor] All right, OK somebody just came. So just call the ambulance make sure that person's with you till the ambulance comes, yeah. Uh and because we are worried about an anaphylactic reaction so you need go straight away. Could you ask the person whether they have any antihistamines around, in the interim, while we're waiting.\n[Patient] Yes, uh Mum, Mum do we have any antihistamines around? Yes.\n[Doctor] Yes K. Do that straight away and if mum can call. Mum, if you can call the uh nine nine , nine nine nine yeah, and say that your there is a suspected anaphylactic reaction and they need to come straight away. OK.\n[Patient] Ohh yeah yeah we do .\n[Patient] Yes she said she will yes, yes.\n[Doctor] All right, so straight away take the antihistamines in the meantime all right.\n[Patient] OK, OK. Yes, thank .\n[Doctor] And after you come out from the hospital do give us a ring back we might need to sort you out, um, with your injections and things like that OK?\n[Patient] Yes, yes will do, yes, thank .\n[Doctor] All . OK then, take care.\n[Patient] Thank you very much thank bye bye.\n[Doctor] Bye bye, bye. ",
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"text": "Good, right, you've mentioned in in, in your patient notes that you're having some sort of lip swelling, and you after you had a sandwich. Is that correct?",
"speaker": "Doctor"
},
{
"start": 66.50088,
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"text": "Yeah that is, well, I don't think, I don't think it was, it it wasn't a sandwich but it was, it was something with prawn so. Basically, I, I sometimes go with my friends to, to this place called . And, we, we regularly have like usually I have like a normal vegetarian soup or something.",
"speaker": "Patient"
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{
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"text": "Mm-hmm.",
"speaker": "Doctor"
},
{
"start": 91.33071,
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"text": "And yeah, and, then I wanted to try something new.",
"speaker": "Patient"
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{
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"text": "Mm-hmm.",
"speaker": "Doctor"
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{
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"text": "Um, so what happened was, I, I ordered a prawn soup it it's it it's called it's like a soup, I ordered a prawn one this time.",
"speaker": "Patient"
},
{
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"text": "Yeah.",
"speaker": "Doctor"
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{
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"text": "And, yeah and then my feel like my lips started feeling a little weird just in the in the corner sort of on the left first.",
"speaker": "Patient"
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"text": "Mm-hmm.",
"speaker": "Doctor"
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"text": "And then, I don't know and then, we went back we had little bit of chat, of banter I wasn't really, paying attention.",
"speaker": "Patient"
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"text": "Uh, now I feel the that there is a swelling, there is like a swelling on my, on my upper lip and it's kind of getting bigger. I don't know what to do.",
"speaker": "Patient"
},
{
"start": 131.28431,
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"text": "Yeah.",
"speaker": "Doctor"
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{
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"text": "Right. All right. So when did you have the prawn soup? What time?",
"speaker": "Doctor"
},
{
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"text": "That was, that must have been just after work, so maybe like around seven.",
"speaker": "Patient"
},
{
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"text": "OK, around seven o'clock, and um how long did it take to develop the swelling?",
"speaker": "Doctor"
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{
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"text": "Well I wasn't really paying attention so, it must have been like, must have been like, I don't know half an hour maybe.",
"speaker": "Patient"
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"text": "OK in half an hour you developed the swelling yeah?",
"speaker": "Doctor"
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"text": "Yeah.",
"speaker": "Patient"
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"text": "OK, and it's getting bigger and bigger?",
"speaker": "Doctor"
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"text": "Yeah it's it it still feel it like, really pumping blood and it's kinda getting bigger it feels like it's getting worse.",
"speaker": "Patient"
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{
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"text": " OK. So, just a few more questions. Um, so you mentioned about your swelling of your lips. Is there any feeling of swelling in in your throat, like your throat is closing up, any feeling like that?",
"speaker": "Doctor"
},
{
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"text": "Yeah actually, I, I feel like I can't breathe that well right now.",
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"text": "OK. And do you feel like, like your chest is tight?",
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"text": "And I don't know if it's the chest it just generally feels a little difficult, but yeah it might be, I'm not sure.",
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"text": "OK.",
"speaker": "Doctor"
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"text": "OK, right. And just a few have you ever these any kind of lip swelling in the past? After eating any food?",
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"text": "Yeah, well, maybe, I remember like a year ago. A year ago I was, out with my friends.",
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"text": "Mm-hmm.",
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"text": "And I think we went like, to a late night kinda Chinese place, and I remember that I was quite drunk to be honest.",
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"text": "And I remember that after like having that very late. I've woke up the next morning quite swollen up and had also I, felt really bad and quite difficult breathing, but I don't know what it was I had it was like a curry or something I think.",
"speaker": "Patient"
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{
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"text": "OK.",
"speaker": "Doctor"
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{
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"text": "Right.",
"speaker": "Doctor"
},
{
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"text": "OK. Uh, and what did you take at that time? Did you use anything like antihistamine or anything, when you had that last time?",
"speaker": "Doctor"
},
{
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"text": "But I generally have asthma so, I took I, I take, ohh what's it called? Salbutamol inhalers?",
"speaker": "Patient"
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{
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"text": "Yeah.",
"speaker": "Doctor"
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{
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"text": "Yeah, so I do take that regularly but I've always taken it. I generally have asthma.",
"speaker": "Patient"
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{
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"text": "And any other inhalers? Is it just the Salbutamol that you use? Any other brown inhalers?",
"speaker": "Doctor"
},
{
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"text": "Ohh I, no I don't think so, no.",
"speaker": "Patient"
},
{
"start": 302.61849,
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"text": " OK right and um so, do you use antihistamines like Cetirizine, Loratadine, Piriton, any of those, kind of things?",
"speaker": "Doctor"
},
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"text": "Hmm, no. I, I got no I do sometimes but I don't know which ones, but I have a peanut allergy as well, like always had it.",
"speaker": "Patient"
},
{
"start": 324.63279,
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"text": "Yeah.",
"speaker": "Doctor"
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{
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"text": "Yeah.",
"speaker": "Doctor"
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{
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"text": "I, think I do get antihistamines for that but I'm not sure which ones.",
"speaker": "Patient"
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{
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"text": "And any point because you had peanut allergy, any time you have to ever use like an injection?",
"speaker": "Doctor"
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{
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"text": "When I was a kid I think I remember my mom told me about it, but I don't know what it was 'cause I was small and I've changed doctors since.",
"speaker": "Patient"
},
{
"start": 349.98043,
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"text": "Right, so has your mum ever said that you had to go to hospital because you had an severe allergic reaction?",
"speaker": "Doctor"
},
{
"start": 357.18658,
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"text": "Yeah is that well I was like six or something I, I, I think. Ohh sorry, the swelling is getting, ohh my god ohh, yeah I think when I was six.",
"speaker": "Patient"
},
{
"start": 365.54789,
"end": 366.12236,
"text": "Oh.",
"speaker": "Doctor"
},
{
"start": 368.32643,
"end": 370.72779,
"text": "You all right? Are you OK now?",
"speaker": "Doctor"
},
{
"start": 371.86004,
"end": 375.53478,
"text": "Ohh, I feel a little dizzy right now to be honest, ohh.",
"speaker": "Patient"
},
{
"start": 371.9238,
"end": 372.86706,
"text": "Are you .",
"speaker": "Doctor"
},
{
"start": 374.51697,
"end": 381.71816,
"text": "You're feeling dizzy. OK, right do you have any kind of, uh, antihistamines with you at the moment?",
"speaker": "Doctor"
},
{
"start": 384.2463,
"end": 387.59995,
"text": " No, I don't think I have no.",
"speaker": "Patient"
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{
"start": 386.59924,
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"text": "OK, right OK, so.",
"speaker": "Doctor"
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{
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"speaker": "Patient"
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{
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"text": "Right, uh, all right I, I'm really a bit worried about you at the moment, Maria. Um I think we need to call an ambulance, because, um, from what history you've been telling me. It sounds like you could be going into what we say an a, an anaphylactic reaction. That's when your throat and your chest, you know closes in and you might need an injection like what your mum's. Um, you know what your mum told you as you were a young child. OK, all right so is there any, anyone with you at the moment or are you alone?",
"speaker": "Doctor"
},
{
"start": 418.24968,
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"text": "",
"speaker": "Patient"
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{
"start": 423.7963,
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"text": "I'm alone at the moment, yeah.",
"speaker": "Patient"
},
{
"start": 425.25064,
"end": 435.37094,
"text": "Ohh no so hang on the line, while I'll call the ambulance OK, and I'll send them right to you, OK and .",
"speaker": "Doctor"
},
{
"start": 434.16563,
"end": 439.6236,
"text": "Hey ohh somebody just came, somebody just came yes, I'm not alone any more. Thank.",
"speaker": "Patient"
},
{
"start": 438.74717,
"end": 459.03517,
"text": "All right, OK somebody just came. So just call the ambulance make sure that person's with you till the ambulance comes, yeah. Uh and because we are worried about an anaphylactic reaction so you need go straight away. Could you ask the person whether they have any antihistamines around, in the interim, while we're waiting.",
"speaker": "Doctor"
},
{
"start": 459.2271,
"end": 464.46977,
"text": "Yes, uh Mum, Mum do we have any antihistamines around? Yes.",
"speaker": "Patient"
},
{
"start": 464.22508,
"end": 481.14587,
"text": "Yes K. Do that straight away and if mum can call. Mum, if you can call the uh nine nine , nine nine nine yeah, and say that your there is a suspected anaphylactic reaction and they need to come straight away. OK.",
"speaker": "Doctor"
},
{
"start": 464.46977,
"end": 467.14123,
"text": "Ohh yeah yeah we do .",
"speaker": "Patient"
},
{
"start": 481.283,
"end": 483.70054,
"text": "Yes she said she will yes, yes.",
"speaker": "Patient"
},
{
"start": 482.89829,
"end": 487.58368,
"text": "All right, so straight away take the antihistamines in the meantime all right.",
"speaker": "Doctor"
},
{
"start": 487.46976,
"end": 490.28436,
"text": "OK, OK. Yes, thank .",
"speaker": "Patient"
},
{
"start": 488.45796,
"end": 498.78006,
"text": "And after you come out from the hospital do give us a ring back we might need to sort you out, um, with your injections and things like that OK?",
"speaker": "Doctor"
},
{
"start": 498.3037,
"end": 502.60227,
"text": "Yes, yes will do, yes, thank .",
"speaker": "Patient"
},
{
"start": 501.49187,
"end": 504.51186,
"text": "All . OK then, take care.",
"speaker": "Doctor"
},
{
"start": 504.77727,
"end": 507.70539,
"text": "Thank you very much thank bye bye.",
"speaker": "Patient"
},
{
"start": 505.73978,
"end": 507.66919,
"text": "Bye bye, bye. ",
"speaker": "Doctor"
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],
"doctor_utterances": "Hi. Hello. Hello, I'm Doctor Jacob and welcome to Babylon. How are you doing? Yeah, so just before we we start, is it all right if you could confirm your full name for me please? OK, day and your date of birth? OK, and your email address for me please? OK, and just to confirm that you're in a secure location and we can have a confidential conversation? Good, right, you've mentioned in in, in your patient notes that you're having some sort of lip swelling, and you after you had a sandwich. Is that correct? Mm-hmm. Mm-hmm. Yeah. Mm-hmm. Yeah. Right. All right. So when did you have the prawn soup? What time? OK, around seven o'clock, and um how long did it take to develop the swelling? OK in half an hour you developed the swelling yeah? OK, and it's getting bigger and bigger? OK. So, just a few more questions. Um, so you mentioned about your swelling of your lips. Is there any feeling of swelling in in your throat, like your throat is closing up, any feeling like that? OK. And do you feel like, like your chest is tight? OK. OK, right. And just a few have you ever these any kind of lip swelling in the past? After eating any food? Mm-hmm. Sure, OK. OK. Right. OK. Uh, and what did you take at that time? Did you use anything like antihistamine or anything, when you had that last time? Yeah. And any other inhalers? Is it just the Salbutamol that you use? Any other brown inhalers? OK right and um so, do you use antihistamines like Cetirizine, Loratadine, Piriton, any of those, kind of things? Yeah. Yeah. And any point because you had peanut allergy, any time you have to ever use like an injection? Right, so has your mum ever said that you had to go to hospital because you had an severe allergic reaction? Oh. You all right? Are you OK now? Are you . You're feeling dizzy. OK, right do you have any kind of, uh, antihistamines with you at the moment? OK, right OK, so. Right, uh, all right I, I'm really a bit worried about you at the moment, Maria. Um I think we need to call an ambulance, because, um, from what history you've been telling me. It sounds like you could be going into what we say an a, an anaphylactic reaction. That's when your throat and your chest, you know closes in and you might need an injection like what your mum's. Um, you know what your mum told you as you were a young child. OK, all right so is there any, anyone with you at the moment or are you alone? Ohh no so hang on the line, while I'll call the ambulance OK, and I'll send them right to you, OK and . All right, OK somebody just came. So just call the ambulance make sure that person's with you till the ambulance comes, yeah. Uh and because we are worried about an anaphylactic reaction so you need go straight away. Could you ask the person whether they have any antihistamines around, in the interim, while we're waiting. Yes K. Do that straight away and if mum can call. Mum, if you can call the uh nine nine , nine nine nine yeah, and say that your there is a suspected anaphylactic reaction and they need to come straight away. OK. All right, so straight away take the antihistamines in the meantime all right. And after you come out from the hospital do give us a ring back we might need to sort you out, um, with your injections and things like that OK? All . OK then, take care. Bye bye, bye. ",
"patient_utterances": "Hi, hi I'm Maria. I'm all right, thank you. Well I feel a little weird today, to be honest. Yes. Maria Trabalotsa. That is the first of October, ninety-nine. Yes, M Traba at Gmail dot com. Yes I think I am, yeah. Yeah that is, well, I don't think, I don't think it was, it it wasn't a sandwich but it was, it was something with prawn so. Basically, I, I sometimes go with my friends to, to this place called . And, we, we regularly have like usually I have like a normal vegetarian soup or something. And yeah, and, then I wanted to try something new. Um, so what happened was, I, I ordered a prawn soup it it's it it's called it's like a soup, I ordered a prawn one this time. And, yeah and then my feel like my lips started feeling a little weird just in the in the corner sort of on the left first. And then, I don't know and then, we went back we had little bit of chat, of banter I wasn't really, paying attention. Uh, now I feel the that there is a swelling, there is like a swelling on my, on my upper lip and it's kind of getting bigger. I don't know what to do. That was, that must have been just after work, so maybe like around seven. Well I wasn't really paying attention so, it must have been like, must have been like, I don't know half an hour maybe. Yeah. Yeah it's it it still feel it like, really pumping blood and it's kinda getting bigger it feels like it's getting worse. Yeah actually, I, I feel like I can't breathe that well right now. And I don't know if it's the chest it just generally feels a little difficult, but yeah it might be, I'm not sure. Yeah, well, maybe, I remember like a year ago. A year ago I was, out with my friends. And I think we went like, to a late night kinda Chinese place, and I remember that I was quite drunk to be honest. And I remember that after like having that very late. I've woke up the next morning quite swollen up and had also I, felt really bad and quite difficult breathing, but I don't know what it was I had it was like a curry or something I think. But I generally have asthma so, I took I, I take, ohh what's it called? Salbutamol inhalers? Yeah, so I do take that regularly but I've always taken it. I generally have asthma. Ohh I, no I don't think so, no. Hmm, no. I, I got no I do sometimes but I don't know which ones, but I have a peanut allergy as well, like always had it. I, think I do get antihistamines for that but I'm not sure which ones. When I was a kid I think I remember my mom told me about it, but I don't know what it was 'cause I was small and I've changed doctors since. Yeah is that well I was like six or something I, I, I think. Ohh sorry, the swelling is getting, ohh my god ohh, yeah I think when I was six. Ohh, I feel a little dizzy right now to be honest, ohh. No, I don't think I have no. I'm alone at the moment, yeah. Hey ohh somebody just came, somebody just came yes, I'm not alone any more. Thank. Yes, uh Mum, Mum do we have any antihistamines around? Yes. Ohh yeah yeah we do . Yes she said she will yes, yes. OK, OK. Yes, thank . Yes, yes will do, yes, thank . Thank you very much thank bye bye.",
"num_turns": 89,
"reference_note": "{\"day\": 3, \"consultation\": 1, \"presenting_complaint\": \"lips swelling after eating a sandwich\", \"note\": \"History: you are having lip swelling for the past 1 hr\\nIt started after eating a prawn soup\\nYou initially had some weird feeling around your lips \\nThe swelling started after half an hour \\nNow you are complaining of your throat closing \\nYour chest is tight at the moment with difficulty breathing \\nExamination : during the consultation, it looked like you were having some problems breathing and your lips appeared to be increasingly swelling\\nPast medical history : you suffer from asthma \\nYou have had an injection as a child for a peanut allergy \\nMedication: you are currently on salbutamol inhalers \\nTreatment: your Mom was around and I have advised that you use an antihistamine straight away. I have advised Mom to call the ambulance as a 999 call as we are suspecting an anaphylactic reaction\\nAfter discharge from hospital please book a review with the doctor to consider prescribing an epipen\\n\", \"highlights\": [\"lip swelling\", \"asthma\", \"peanut allergy\", \"anaphylactic reaction\"]}",
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"dialogue": "[Doctor] Hello, hi, I'm Doctor Jacob and welcome to Babylon.\n[Patient] Hi. \n[Doctor] Hi. So, just before we start is it alright if you could confirm your name for me please?\n[Patient] Yep, uh, John Doe.\n[Doctor] OK and your date of birth? \n[Patient] Uhh, twenty-one twelve and nineteen uh eighty-six.\n[Doctor] And, your address for me, please?\n[Patient] Is, uh, number one London Street. Um, NW three six PQ.\n[Doctor] \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] We are, yes.\n[Doctor] OK. So I understand you're having a a headache is that correct?\n[Patient] Uh yeah, iIve had a, um a sort of a, a, a very sort of bad, severe headache, the past four days. Um, and um I've been sort of feeling a bit hot as well. Um, I've got, got a bit of a temperature, I think.\n[Doctor] \n[Patient] I haven't measured it but um, think I've, yeah, I think I've got a fever.\n[Doctor] OK. Right. And um, so what started first, was it the headache or the fever?\n[Patient] Um, so um, headache started uh, first. Um, and then sort of yeah, fever sort of came along a bit afterwards.\n[Doctor] OK, afterwards, right. And what have you taken so far for your headache?\n[Patient] Um, so I've had some Paracetamol and some Ibuprofen, but it's not really helping at the moment.\n[Doctor] OK. so just a few more questions, with regards to your headache So do you find it difficult to look at the light?\n[Patient] Yep.\n[Patient] Um no, like um it, it's fine, light doesn't seem to bother me too much.\n[Doctor] OK. Uh, and is it any pain when you try to move your neck from side to side, look up and down, is there any pain?\n[Patient] And I've got some general aching muscles. Um, not necessarily sort of in my neck. It's kind of a bit all over, really.\n[Doctor] OK, all over. Right, and have you been sick with this headache?\n[Patient] No, no I haven't, I haven't been sick.\n[Doctor] OK, and do you have a cough?\n[Patient] Uh no, no cough.\n[Doctor] OK, so there's no cough or cold, yeah?\n[Patient] Uh, no. No.\n[Doctor] OK, and you your ears are OK? There's no earaches?\n[Patient] Um, no it's, it seems to be OK. It, it's fine.\n[Doctor] OK, all right. And with this headache have you experienced any pins and needles in your face, arms and legs?\n[Patient] Uh, no.\n[Doctor] No pins and needles. Any muscle weaknesses at all?\n[Patient] Um just, I, I suppose general aching, body aching.\n[Doctor] Not, not any weakness but where you couldn't, you know, hold a cup or anything like that, that's what I mean.\n[Patient] Uh, no. I'm, I'm sort of, yeah, seem to be sort of fine with that sort of stuff but, yeah.\n[Doctor] Ohh Okay, and um just a few more questions to you, because I don't have any of your background history. Um, do you suffer from any medical conditions?\n[Patient] Uh no, um general medical history is fine.\n[Doctor] Fine. And no surgical history then and no medical surgical complaints, yeah?\n[Patient] Uh, no. Um, I, I suppose uh I have been away to um, uh, Thailand. Um, uh week or so ago. Um\n[Doctor] \n[Patient] had some, like, usual mosquito bites from sort of traveling around and a friend of mine has also been a bit unwell, but um, uh, yeah, that 's the only sort of, like, history per se.\n[Doctor] Right, and um, do you have any kind of shivering at all? Do you shivering with the fever?\n[Patient] Um, I um, uh, I I do feel cold quite a lot. Uh, you know it's, um, I no sort of shivering, but definitely like a bit cold.\n[Doctor] cold, yeah? OK, right. And are you using you mentioned about the paracetamol and now, but are you on any regular, any medication, anything that you're using at all?\n[Patient] Yep.\n[Patient] Uh, no.\n[Doctor] OK. Um, any allergies at all?\n[Patient] Uh, no. Um\n[Doctor] Alright. OK and... OK, so uh I, I believe that it is quite important for us to actually examine you, yeah? Um, it it's not possible for us to do that online. I think you would need to come into one of our hubs to have a proper examination, and I, I think you would need one quite urgently, OK? So the thing that's running in the back of my mind are um, kind of a viral illnesses that can one can get with um, sort of mosquito bites or foreign travel.\n[Patient] OK.\n[Doctor] Like , um the other common thing around Thailand, it will be like some dengue. But that would have, like you would have some, uh, blood spots or bleeding or something, which you don't have at the moment, do you?\n[Patient] OK.\n[Patient] Uh no. I mean I've got a bit of a rash, but nothing like, uh no, no, no, no bleeding.\n[Doctor] OK. So where is the rash?\n[Patient] Um, it's uh, the rash is kind of all over my body. Like it's not, it's not, it's not really localised.\n[Doctor] How would you describe, how would you describe the rash?\n[Patient] Um uh sort of red and itchy.\n[Doctor] Red and itchy. OK. So if you were to put a glass on top of the rash, does that rash go away?\n[Patient] Yeah.\n[Patient] Uh, yes.\n[Doctor] It goes away. OK.\n[Doctor] OK. So what we need to do, need to urgently examine you. And that's sometime today. OK? And um, after our examination there is a high possibility that sometimes we might need to send you to hospital. But I'm not sure as yet. So I'd like you to be seen in one of our hubs as soon as possible?\n[Patient] OK.\n[Patient] OK.\n[Doctor] So um, I'll recommend that you would need to be urgently seen by the doctor, preferably in the next few hours time. OK? And um, in any case if that's not available I'd like you to take yourself to . Alright? Any questions at all?\n[Patient] OK.\n[Patient] OK.\n[Patient] Uh, no. Sounds serious.\n[Doctor] , you know obviously when I've spoken to you, you, you didn't tick the box for many theories, but you're in the middle somewhere. Let's put it that way.\n[Patient] OK.\n[Doctor] Um you know things like we have to rule out is Meningitis and all, but Ben, you just have a general muscle ache. You didn't say that you had things like, you had problems looking at the light or something Those are things when you think of Meningitis But and then, it's the uh, in meningitis you get a non-blanching rash. While in any kind of virus the rash usually goes away. Saying that, we don't know whether these are the beginning stage. So that's why I'd rather, but I would rather you see a GP as soon as possible, if uh, we've got a slot available. But if not, I think you need to be seen, and maybe have some blood tests and examinations. OK?\n[Patient] OK, cool. Thank you very much.\n[Doctor] All right, you take care, Ben. Bye now. Cheers. Bye.\n[Patient] Bye.",
"turns": [
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"text": " Hello, hi, I'm Doctor Jacob and welcome to Babylon.",
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"text": "Hi. ",
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"text": "Hi. So, just before we start is it alright if you could confirm your name for me please?",
"speaker": "Doctor"
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"text": "Yep, uh, John Doe.",
"speaker": "Patient"
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"text": "OK and your date of birth? ",
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"text": "Uhh, twenty-one twelve and nineteen uh eighty-six.",
"speaker": "Patient"
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"text": "And, your address for me, please?",
"speaker": "Doctor"
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"text": "Is, uh, number one London Street. Um, NW three six PQ.",
"speaker": "Patient"
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"speaker": "Doctor"
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"text": "That's correct. And just to confirm that you're in a secure location and we can have a confidential conversation?",
"speaker": "Doctor"
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"text": "We are, yes.",
"speaker": "Patient"
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"text": "OK. So I understand you're having a a headache is that correct?",
"speaker": "Doctor"
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"text": "Uh yeah, iIve had a, um a sort of a, a, a very sort of bad, severe headache, the past four days. Um, and um I've been sort of feeling a bit hot as well. Um, I've got, got a bit of a temperature, I think.",
"speaker": "Patient"
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"text": "I haven't measured it but um, think I've, yeah, I think I've got a fever.",
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"text": "OK. Right. And um, so what started first, was it the headache or the fever?",
"speaker": "Doctor"
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"text": "Um, so um, headache started uh, first. Um, and then sort of yeah, fever sort of came along a bit afterwards.",
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"text": "OK, afterwards, right. And what have you taken so far for your headache?",
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"text": "Um, so I've had some Paracetamol and some Ibuprofen, but it's not really helping at the moment.",
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"text": " OK. so just a few more questions, with regards to your headache So do you find it difficult to look at the light?",
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"speaker": "Patient"
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"text": "Um no, like um it, it's fine, light doesn't seem to bother me too much.",
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"text": "OK. Uh, and is it any pain when you try to move your neck from side to side, look up and down, is there any pain?",
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"text": "And I've got some general aching muscles. Um, not necessarily sort of in my neck. It's kind of a bit all over, really.",
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"text": "Uh, no. I'm, I'm sort of, yeah, seem to be sort of fine with that sort of stuff but, yeah.",
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"text": "Ohh Okay, and um just a few more questions to you, because I don't have any of your background history. Um, do you suffer from any medical conditions?",
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"speaker": "Doctor"
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"speaker": "Patient"
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"text": "Uh, no. Um",
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"text": "Alright. OK and... OK, so uh I, I believe that it is quite important for us to actually examine you, yeah? Um, it it's not possible for us to do that online. I think you would need to come into one of our hubs to have a proper examination, and I, I think you would need one quite urgently, OK? So the thing that's running in the back of my mind are um, kind of a viral illnesses that can one can get with um, sort of mosquito bites or foreign travel.",
"speaker": "Doctor"
},
{
"start": 263.99686,
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"text": "OK.",
"speaker": "Patient"
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{
"start": 289.55531,
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"text": "Like , um the other common thing around Thailand, it will be like some dengue. But that would have, like you would have some, uh, blood spots or bleeding or something, which you don't have at the moment, do you?",
"speaker": "Doctor"
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{
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"text": "OK.",
"speaker": "Patient"
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{
"start": 303.00552,
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"text": "Uh no. I mean I've got a bit of a rash, but nothing like, uh no, no, no, no bleeding.",
"speaker": "Patient"
},
{
"start": 310.40717,
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"text": "OK. So where is the rash?",
"speaker": "Doctor"
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{
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"text": "Um, it's uh, the rash is kind of all over my body. Like it's not, it's not, it's not really localised.",
"speaker": "Patient"
},
{
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"text": "How would you describe, how would you describe the rash?",
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"speaker": "Patient"
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{
"start": 329.43623,
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"text": "Red and itchy. OK. So if you were to put a glass on top of the rash, does that rash go away?",
"speaker": "Doctor"
},
{
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"text": "Yeah.",
"speaker": "Patient"
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{
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"text": "Uh, yes.",
"speaker": "Patient"
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"text": "It goes away. OK.",
"speaker": "Doctor"
},
{
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"text": "OK. So what we need to do, need to urgently examine you. And that's sometime today. OK? And um, after our examination there is a high possibility that sometimes we might need to send you to hospital. But I'm not sure as yet. So I'd like you to be seen in one of our hubs as soon as possible?",
"speaker": "Doctor"
},
{
"start": 347.50239,
"end": 349.48024,
"text": " OK.",
"speaker": "Patient"
},
{
"start": 362.84715,
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"text": "OK.",
"speaker": "Patient"
},
{
"start": 362.88566,
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"text": "So um, I'll recommend that you would need to be urgently seen by the doctor, preferably in the next few hours time. OK? And um, in any case if that's not available I'd like you to take yourself to . Alright? Any questions at all?",
"speaker": "Doctor"
},
{
"start": 372.35314,
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"text": "OK.",
"speaker": "Patient"
},
{
"start": 379.16439,
"end": 379.99219,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 382.39585,
"end": 385.05673,
"text": "Uh, no. Sounds serious.",
"speaker": "Patient"
},
{
"start": 385.92925,
"end": 394.20465,
"text": ", you know obviously when I've spoken to you, you, you didn't tick the box for many theories, but you're in the middle somewhere. Let's put it that way.",
"speaker": "Doctor"
},
{
"start": 394.08805,
"end": 394.93358,
"text": "OK.",
"speaker": "Patient"
},
{
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"text": "Um you know things like we have to rule out is Meningitis and all, but Ben, you just have a general muscle ache. You didn't say that you had things like, you had problems looking at the light or something Those are things when you think of Meningitis But and then, it's the uh, in meningitis you get a non-blanching rash. While in any kind of virus the rash usually goes away. Saying that, we don't know whether these are the beginning stage. So that's why I'd rather, but I would rather you see a GP as soon as possible, if uh, we've got a slot available. But if not, I think you need to be seen, and maybe have some blood tests and examinations. OK?",
"speaker": "Doctor"
},
{
"start": 435.91965,
"end": 438.22656,
"text": "OK, cool. Thank you very much.",
"speaker": "Patient"
},
{
"start": 437.92838,
"end": 441.5828,
"text": "All right, you take care, Ben. Bye now. Cheers. Bye.",
"speaker": "Doctor"
},
{
"start": 439.62781,
"end": 441.28783,
"text": " Bye.",
"speaker": "Patient"
}
],
"doctor_utterances": " Hello, hi, I'm Doctor Jacob and welcome to Babylon. Hi. So, just before we start is it alright if you could confirm your name for me please? OK and your date of birth? And, your 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? OK. So I understand you're having a a headache is that correct? OK. Right. And um, so what started first, was it the headache or the fever? OK, afterwards, right. And what have you taken so far for your headache? OK. so just a few more questions, with regards to your headache So do you find it difficult to look at the light? OK. Uh, and is it any pain when you try to move your neck from side to side, look up and down, is there any pain? OK, all over. Right, and have you been sick with this headache? OK, and do you have a cough? OK, so there's no cough or cold, yeah? OK, and you your ears are OK? There's no earaches? OK, all right. And with this headache have you experienced any pins and needles in your face, arms and legs? No pins and needles. Any muscle weaknesses at all? Not, not any weakness but where you couldn't, you know, hold a cup or anything like that, that's what I mean. Ohh Okay, and um just a few more questions to you, because I don't have any of your background history. Um, do you suffer from any medical conditions? Fine. And no surgical history then and no medical surgical complaints, yeah? Right, and um, do you have any kind of shivering at all? Do you shivering with the fever? cold, yeah? OK, right. And are you using you mentioned about the paracetamol and now, but are you on any regular, any medication, anything that you're using at all? OK. Um, any allergies at all? Alright. OK and... OK, so uh I, I believe that it is quite important for us to actually examine you, yeah? Um, it it's not possible for us to do that online. I think you would need to come into one of our hubs to have a proper examination, and I, I think you would need one quite urgently, OK? So the thing that's running in the back of my mind are um, kind of a viral illnesses that can one can get with um, sort of mosquito bites or foreign travel. Like , um the other common thing around Thailand, it will be like some dengue. But that would have, like you would have some, uh, blood spots or bleeding or something, which you don't have at the moment, do you? OK. So where is the rash? How would you describe, how would you describe the rash? Red and itchy. OK. So if you were to put a glass on top of the rash, does that rash go away? It goes away. OK. OK. So what we need to do, need to urgently examine you. And that's sometime today. OK? And um, after our examination there is a high possibility that sometimes we might need to send you to hospital. But I'm not sure as yet. So I'd like you to be seen in one of our hubs as soon as possible? So um, I'll recommend that you would need to be urgently seen by the doctor, preferably in the next few hours time. OK? And um, in any case if that's not available I'd like you to take yourself to . Alright? Any questions at all? , you know obviously when I've spoken to you, you, you didn't tick the box for many theories, but you're in the middle somewhere. Let's put it that way. Um you know things like we have to rule out is Meningitis and all, but Ben, you just have a general muscle ache. You didn't say that you had things like, you had problems looking at the light or something Those are things when you think of Meningitis But and then, it's the uh, in meningitis you get a non-blanching rash. While in any kind of virus the rash usually goes away. Saying that, we don't know whether these are the beginning stage. So that's why I'd rather, but I would rather you see a GP as soon as possible, if uh, we've got a slot available. But if not, I think you need to be seen, and maybe have some blood tests and examinations. OK? All right, you take care, Ben. Bye now. Cheers. Bye.",
"patient_utterances": "Hi. Yep, uh, John Doe. Uhh, twenty-one twelve and nineteen uh eighty-six. Is, uh, number one London Street. Um, NW three six PQ. We are, yes. Uh yeah, iIve had a, um a sort of a, a, a very sort of bad, severe headache, the past four days. Um, and um I've been sort of feeling a bit hot as well. Um, I've got, got a bit of a temperature, I think. I haven't measured it but um, think I've, yeah, I think I've got a fever. Um, so um, headache started uh, first. Um, and then sort of yeah, fever sort of came along a bit afterwards. Um, so I've had some Paracetamol and some Ibuprofen, but it's not really helping at the moment. Yep. Um no, like um it, it's fine, light doesn't seem to bother me too much. And I've got some general aching muscles. Um, not necessarily sort of in my neck. It's kind of a bit all over, really. No, no I haven't, I haven't been sick. Uh no, no cough. Uh, no. No. Um, no it's, it seems to be OK. It, it's fine. Uh, no. Um just, I, I suppose general aching, body aching. Uh, no. I'm, I'm sort of, yeah, seem to be sort of fine with that sort of stuff but, yeah. Uh no, um general medical history is fine. Uh, no. Um, I, I suppose uh I have been away to um, uh, Thailand. Um, uh week or so ago. Um had some, like, usual mosquito bites from sort of traveling around and a friend of mine has also been a bit unwell, but um, uh, yeah, that 's the only sort of, like, history per se. Um, I um, uh, I I do feel cold quite a lot. Uh, you know it's, um, I no sort of shivering, but definitely like a bit cold. Yep. Uh, no. Uh, no. Um OK. OK. Uh no. I mean I've got a bit of a rash, but nothing like, uh no, no, no, no bleeding. Um, it's uh, the rash is kind of all over my body. Like it's not, it's not, it's not really localised. Um uh sort of red and itchy. Yeah. Uh, yes. OK. OK. OK. OK. Uh, no. Sounds serious. OK. OK, cool. Thank you very much. Bye.",
"num_turns": 77,
"reference_note": "{\"day\": 3, \"consultation\": 2, \"presenting_complaint\": \"feeling hot and having severe headache\", \"note\": \"You are having a headache for the past 4 days \\nYou have been taking paracetamol and ibuprofen but no relief \\nYou have just returned from Thailand a week ago and a friend of your is also unwell \\nYou have had mosquito bites \\nYou have a rash all over your body but this disappears when a glass is placed ( blanching)\\nThere is no pain while you move your neck \\nThere is no pain while looking at the light \\nThere is no weakness of the muscles \\nThere is no pins and needles \\nYou do not have vomiting \\nThere is no no cough, cold or ear pain\\nThere is no bleeding spots over the skin \\nYou have some generalized muscle aches \\nPast medical history None\\nNo allergies \\nPlan : you have been advised to book an urgent appointment to see a doctor in the next few hours\\nIf this is not possible you will need to go to A & E . WE will need to r/o more serious conditions like malaria, Dengue and meningitis \\n\", \"highlights\": [\"headache\", \"mosquito bites\", \"No allergies\"]}",
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"dialogue": "[Doctor] Hello?\n[Doctor] Hello, can you hear me?\n[Patient] Hi, I can hear you. Can you hear me?\n[Doctor] Yes, I can. Hi, I'm Dr. Jacob and welcome to Babylon. How are you doing?\n[Patient] Hello, I'm Peter. I'm, I'm doing OK, I guess.\n[Doctor] OK Peter, so just before we , is it alright if you could confirm your full name for me please?\n[Patient] \n[Patient] That's Peter Peterson.\n[Doctor] OK, and your date of birth?\n[Patient] Um, I'm, I'm thirty five years old. That's gonna be difficult now. \n[Doctor] . And uh, and um, what's your email address?\n[Patient] My email address is Peter dot Peterson at dot co dot UK\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] I am. That's right, thank you very much.\n[Doctor] Alright. So, you've mentioned that you're not having much of an appetite and energy lately. I'm sorry to hear that. Could you tell me a bit more about it please?\n[Patient] Ohh, that's right . Started long, long ago now. Uh, that have been feeling down and, and didn't really have yeah, energy. Um, my, my, my wife was starting to complain as well, uh in, in nightly activities.\n[Doctor] \n[Patient] And um, I just felt like I, I needed to call you guys and needed to get some, some more information about what could be going on. Um, it's just that, yeah, nothing is like, feeling right and I feel out of place. And, and, it's, it's, yeah, just down .\n[Doctor] So, so you, are you telling me that your, your mood's low? Is that what you're trying to tell me?\n[Patient] Um. Yes, and like I'm feeling short of breath, breath it's like always yeah, out of energy I would say, yes, definitely .\n[Doctor] your mood, would you say you're depressed?\n[Patient] Um.\n[Patient] Are you, you never want to say that do you? \n[Doctor] it's a tough one isn't it? Because we don't want to actually say\n[Patient] I mean, I mean, work is OK. Um, I have trouble at work sometimes, having headaches, feeling nauseous. Um, uh I can do my work that's. that's OK .\n[Doctor] Uh do you like your work? Do you like your work?\n[Patient] Again?\n[Patient] Um, who likes to be a lawyer? Sorry, that was mean. Um Yes, of course I like, I like.\n[Doctor] You like your work. OK. And um you, and how are things at home? Alright? Are you having any kind of stress at home?\n[Patient] Um, it is OK. Uh, sometimes, because I'm having a loss of appetite, I'm, uh, yeah I'm not eating very much, and . Um, other than that, it's, it's OK, yeah.\n[Doctor] And have you lost any weight?\n[Patient] I have, a little bit, yes. Uh, but, uh, but that's, that's Over, over long period now.\n[Doctor] OK, right. So you mentioned that you've lost your appetite for a while now. So how long are we talking about?\n[Patient] It must have started when I When I changed over to the new law firm. Uh, I would say months ago.\n[Doctor] We talking about two months, three months, or six months ?\n[Patient] Uh, uh. Three months ago, three and a half months ago, that was.\n[Doctor] and a half months ago. But you said your weight loss is much longer than that?\n[Patient] Yeah it stopped doing that, uh, yeah.\n[Doctor] Sorry, could you , I couldn't hear you. What did you say, your weight loss, how long?\n[Patient] It started a little bit earlier than that. I, I, I'm not sure, though, how it's gonna \n[Doctor] at least six months, would you say?\n[Patient] Uh.\n[Patient] Something like that, yeah.\n[Doctor] six months. And roughly how much have you lost? Just approximately.\n[Patient] Ohh gosh. I would say, less than a storm, something like that.\n[Doctor] So about a stone, yeah? Six months, OK. OK. , OK. Right, OK. So, just a few more questions. It might seem a bit awkward, but it's quite relevant. OK? So, how are your bowels? Are they OK?\n[Patient] \n[Patient] \n[Patient] Um, I feel nauseous every now and again. Uh, it, it's, it's coming up, uh, yeah, it's just every now and again not feeling very good. Uh, trying to eat something, but don't really want to.\n[Doctor] \n[Doctor] Yeah, um, your bowels. How's your toilet?\n[Patient] Uh. That's OK, I would say. Uh, I don't really have problems when going to the toilet, it's just painless.\n[Doctor] OK.\n[Doctor] So, you're not going to the toilet?\n[Patient] Yes. Yes.\n[Doctor] you are going. Like, to be very more specific, you don't have any diarrhoea?\n[Patient] Uh, no. No diarrhoea. No,no .\n[Doctor] OK, so there's blood in the poo no mucus nothing of that sort?\n[Patient] Uh.\n[Patient] Uh, no, no, nothing.\n[Doctor] Just now, you mentioned nausea. Have you been ever sick with it?\n[Patient] No, actually not. Uh, . Yeah I'm feeling not well, uh, in the, in the, in the bowel region, yeah.\n[Doctor] \n[Doctor] OK, well just the nausea, OK. Is there any particular foods that make you nauseous?\n[Patient] Nauseous.\n[Patient] No, nothing.\n[Doctor] OK. So you can't think of any real.... Do you suffer from acid reflux?\n[Patient] I do not, no.\n[Doctor] OK, OK. You also mentioned that you're feeling short of breath so yeah is there any cough?\n[Patient] \n[Patient] Um, no, not really just, just \n[Doctor] OK.\n[Patient] It's like when, when when I go into the lift, uh, it, it happens to be that, uh, I like, you know, my heart starts beating and I can't really breath, uh\n[Doctor] Yeah. Is it like in closed spaces?\n[Patient] \n[Patient] No, it happens every time. It happens very significantly in, in the lift or when I'm, when I'm \n[Doctor] So, how far can you walk and when you start feeling short of breath? So how far can you walk with no shortness of breath? \n[Patient] Um. Walk or run. \n[Doctor] Walk, you start with walk. Do you feel short of breathlet's start this way, do you feel short of uh breath when you walk at all?\n[Patient] No, actually not. \n[Doctor] Right. You so you can walk about a mile and you don't feel short of breath at all.\n[Patient] That's right, yes.\n[Doctor] OK, so just explain a bit more just make myself clear about the lift thing. So you said you're short of breath when you're in the lift?\n[Patient] Yeah, my heart starts beating. I, I feel like I can't breathe and, and, uh, it's, it's very difficult too. Uh yeah, two twenty nine. Uh, it's going, yeah just, just that you, you know, when, when you just feel unwell, and yeah, your heart starts beating.\n[Doctor] described them like palpitations to me, yeah? So that's what you're, you're feeling your own heartbeat.\n[Patient] Yep \n[Doctor] Yeah, OK. You get any chest pains with it?\n[Patient] Not really, no. It's just that \n[Doctor] OK.\n[Doctor] OK, no chest pains.\n[Patient] I'm up. No chest pain. \n[Doctor] OK. Alright. Fine. So, what we need to do, um, just before that, um, just a few more things. Uh, any any past medical history you'd like to share with me today?\n[Patient] Uh, yes. I had too little activity of my thyroid, uh.\n[Doctor] Sorry you had thyroid problems.\n[Patient] Thyroid. Too little activity, yes.\n[Doctor] Ohh yeah, underactive thyroid, yes. Yep.\n[Patient] Um, yeah, yeah, yeah. Um, and in, in In view of that, I took thyroxine.\n[Doctor] Yeah, you're taking thyroxine? Are you using it every day?\n[Patient] \n[Patient] Uh, not anymore.\n[Doctor] Why is that?\n[Patient] Uh, I have, I have not been taking it in the last, actually since I changed doctor, I would say.\n[Doctor] OK, so is that, so all these things are since you've stopped taking the thyroxine?\n[Patient] Ohh. That might be coinciding, I'm not sure about that.\n[Doctor] When was your last blood test?\n[Patient] Uh, haven't taken one in a long time.\n[Doctor] OK, so you've not had a blood test.\n[Patient] Mm hmm\n[Doctor] Right, OK. It could, you know, generally for you know for underactive thyroids what symptoms you've said um it's the opposite that usually happens, yeah. It's for overactive thyroid like you can feel a bit like the racing of your heart beat and all so I'm not quite clear on what picture we are having here. Yeah?\n[Patient] OK.\n[Doctor] I think a general set of bloods is a good , good start. So what we look at, because you're not, you're not having the umph, aren't you? You're like, you're just feeling a bit, you know low and things like that, right? Well, um, and weak and things like that. So we'll just do a general set of bloods. we look at things like anaemia, how your kidney functions are, your livers, all that, with vitamin levels, and your .\n[Patient] OK.\n[Patient] yes.\n[Patient] No problem.\n[Doctor] OK. And uh, now after we get those set of bloods, we will find out if we can find anything in them. If that's all clear, then we would need to do a physical examination. OK?\n[Patient] Uh huh\n[Patient] Okay.\n[Doctor] We would need to then go in and do . But there's nothing from what your history you've said that, that we urgently warrant a physical examination at this point in time. I think it's a good idea to start off with a blood test, and then take it from there.\n[Patient] OK.\n[Doctor] Obviously with palpitations or chest pain, if you get that's more of a medical emergency. You need to go to A and E for that. OK? If things change, you've mentioned now your bowels are fine, and you're not being sick. So if that's the case it's OK, but if your, you know, bowels change or you're being sick again, you need to get in touch with us. OK? \n[Patient] OK, I have, I haven't been walking lately at all. I haven't, yes. I haven't been walking lately at all so like, it's really hard for me to identify when I feel the shortness of breath.\n[Doctor] Sorry? Could you repeat that?\n[Doctor] Mm-hmm.\n[Patient] Uh, just wanted to add that into , because, um, I haven't been walking. I haven't been feeling good enough for a good at all. So, yep.\n[Doctor] OK. So let's do all the blood tests first and we'll take it from there. OK? But you know, if you have any chest pains, or change in bowel habits, do get in touch with us.\n[Patient] Thank you. \n[Patient] I will, yes.\n[Doctor] OK. Now what we need to do is now you need to ring up support. And I'll the form for you, but in the interim you need to call support so that we can organise that blood test for you. And when you get the result, you will receive a text message through your phone to tell you to book an appointment. If you're feeling poorly, don't wait for that. Just get in touch with us again, yeah?\n[Patient] Uh huh.\n[Patient] \n[Patient] OK. Can I\n[Patient] I will. How do I call to report?\n[Doctor] Ohh, there's a number on your app, yeah? If you open up your app there's the number on there. It's an oh three hundred number, yeah? So just call that number.\n[Patient] OK.\n[Patient] I will find it, thank you.\n[Doctor] Alright then. You take care. Bye now.\n[Patient] Thank you, ciao.\n[Doctor] Ciao, bye.",
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"text": "Yeah. Is it like in closed spaces?",
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"text": "No, it happens every time. It happens very significantly in, in the lift or when I'm, when I'm ",
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"text": "So, how far can you walk and when you start feeling short of breath? So how far can you walk with no shortness of breath? ",
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"text": "Um. Walk or run. ",
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"text": "Walk, you start with walk. Do you feel short of breathlet's start this way, do you feel short of uh breath when you walk at all?",
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"text": "No, actually not. ",
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"text": "Right. You so you can walk about a mile and you don't feel short of breath at all.",
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"text": "That's right, yes.",
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"text": "OK, so just explain a bit more just make myself clear about the lift thing. So you said you're short of breath when you're in the lift?",
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"text": "Yeah, my heart starts beating. I, I feel like I can't breathe and, and, uh, it's, it's very difficult too. Uh yeah, two twenty nine. Uh, it's going, yeah just, just that you, you know, when, when you just feel unwell, and yeah, your heart starts beating.",
"speaker": "Patient"
},
{
"start": 434.42076,
"end": 440.52664,
"text": " described them like palpitations to me, yeah? So that's what you're, you're feeling your own heartbeat.",
"speaker": "Doctor"
},
{
"start": 440.49779,
"end": 442.79524,
"text": "Yep ",
"speaker": "Patient"
},
{
"start": 441.05058,
"end": 445.00648,
"text": "Yeah, OK. You get any chest pains with it?",
"speaker": "Doctor"
},
{
"start": 445.91403,
"end": 450.24099,
"text": "Not really, no. It's just that ",
"speaker": "Patient"
},
{
"start": 447.27791,
"end": 448.27791,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 450.32076,
"end": 452.42076,
"text": "OK, no chest pains.",
"speaker": "Doctor"
},
{
"start": 451.62785,
"end": 454.75853,
"text": "I'm up. No chest pain. ",
"speaker": "Patient"
},
{
"start": 454.67791,
"end": 468.57791,
"text": "OK. Alright. Fine. So, what we need to do, um, just before that, um, just a few more things. Uh, any any past medical history you'd like to share with me today?",
"speaker": "Doctor"
},
{
"start": 468.49504,
"end": 473.86949,
"text": "Uh, yes. I had too little activity of my thyroid, uh.",
"speaker": "Patient"
},
{
"start": 472.99219,
"end": 476.09219,
"text": " Sorry you had thyroid problems.",
"speaker": "Doctor"
},
{
"start": 475.93484,
"end": 478.50012,
"text": "Thyroid. Too little activity, yes.",
"speaker": "Patient"
},
{
"start": 478.07791,
"end": 481.57791,
"text": "Ohh yeah, underactive thyroid, yes. Yep.",
"speaker": "Doctor"
},
{
"start": 480.71425,
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"text": "Um, yeah, yeah, yeah. Um, and in, in In view of that, I took thyroxine.",
"speaker": "Patient"
},
{
"start": 487.79219,
"end": 492.30648,
"text": "Yeah, you're taking thyroxine? Are you using it every day?",
"speaker": "Doctor"
},
{
"start": 489.52913,
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"text": "",
"speaker": "Patient"
},
{
"start": 493.02894,
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"text": "Uh, not anymore.",
"speaker": "Patient"
},
{
"start": 494.86362,
"end": 496.3779,
"text": "Why is that?",
"speaker": "Doctor"
},
{
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"text": "Uh, I have, I have not been taking it in the last, actually since I changed doctor, I would say.",
"speaker": "Patient"
},
{
"start": 501.76362,
"end": 508.0779,
"text": "OK, so is that, so all these things are since you've stopped taking the thyroxine?",
"speaker": "Doctor"
},
{
"start": 508.66439,
"end": 513.90816,
"text": "Ohh. That might be coinciding, I'm not sure about that.",
"speaker": "Patient"
},
{
"start": 513.70648,
"end": 516.33505,
"text": "When was your last blood test?",
"speaker": "Doctor"
},
{
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"end": 519.40177,
"text": "Uh, haven't taken one in a long time.",
"speaker": "Patient"
},
{
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"end": 521.73505,
"text": "OK, so you've not had a blood test.",
"speaker": "Doctor"
},
{
"start": 521.71113,
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"text": "Mm hmm",
"speaker": "Patient"
},
{
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"text": "Right, OK. It could, you know, generally for you know for underactive thyroids what symptoms you've said um it's the opposite that usually happens, yeah. It's for overactive thyroid like you can feel a bit like the racing of your heart beat and all so I'm not quite clear on what picture we are having here. Yeah?",
"speaker": "Doctor"
},
{
"start": 537.19159,
"end": 537.89996,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 547.09219,
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"text": "I think a general set of bloods is a good , good start. So what we look at, because you're not, you're not having the umph, aren't you? You're like, you're just feeling a bit, you know low and things like that, right? Well, um, and weak and things like that. So we'll just do a general set of bloods. we look at things like anaemia, how your kidney functions are, your livers, all that, with vitamin levels, and your .",
"speaker": "Doctor"
},
{
"start": 547.92031,
"end": 548.70838,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 561.12604,
"end": 562.24266,
"text": " yes.",
"speaker": "Patient"
},
{
"start": 573.15809,
"end": 573.92597,
"text": "No problem.",
"speaker": "Patient"
},
{
"start": 574.36362,
"end": 587.69219,
"text": "OK. And uh, now after we get those set of bloods, we will find out if we can find anything in them. If that's all clear, then we would need to do a physical examination. OK?",
"speaker": "Doctor"
},
{
"start": 575.4021,
"end": 576.11643,
"text": "Uh huh",
"speaker": "Patient"
},
{
"start": 587.30683,
"end": 587.92949,
"text": "Okay.",
"speaker": "Patient"
},
{
"start": 587.69219,
"end": 602.60151,
"text": "We would need to then go in and do . But there's nothing from what your history you've said that, that we urgently warrant a physical examination at this point in time. I think it's a good idea to start off with a blood test, and then take it from there.",
"speaker": "Doctor"
},
{
"start": 588.75995,
"end": 589.22814,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 602.60151,
"end": 624.03381,
"text": "Obviously with palpitations or chest pain, if you get that's more of a medical emergency. You need to go to A and E for that. OK? If things change, you've mentioned now your bowels are fine, and you're not being sick. So if that's the case it's OK, but if your, you know, bowels change or you're being sick again, you need to get in touch with us. OK? ",
"speaker": "Doctor"
},
{
"start": 622.20033,
"end": 634.24062,
"text": "OK, I have, I haven't been walking lately at all. I haven't, yes. I haven't been walking lately at all so like, it's really hard for me to identify when I feel the shortness of breath.",
"speaker": "Patient"
},
{
"start": 625.56096,
"end": 627.83504,
"text": "Sorry? Could you repeat that?",
"speaker": "Doctor"
},
{
"start": 634.12103,
"end": 634.74192,
"text": "Mm-hmm.",
"speaker": "Doctor"
},
{
"start": 634.24062,
"end": 644.14427,
"text": "Uh, just wanted to add that into , because, um, I haven't been walking. I haven't been feeling good enough for a good at all. So, yep.",
"speaker": "Patient"
},
{
"start": 643.32589,
"end": 653.3143,
"text": "OK. So let's do all the blood tests first and we'll take it from there. OK? But you know, if you have any chest pains, or change in bowel habits, do get in touch with us.",
"speaker": "Doctor"
},
{
"start": 646.47149,
"end": 648.90608,
"text": "Thank you. ",
"speaker": "Patient"
},
{
"start": 653.99581,
"end": 655.25648,
"text": "I will, yes.",
"speaker": "Patient"
},
{
"start": 654.4779,
"end": 677.54933,
"text": "OK. Now what we need to do is now you need to ring up support. And I'll the form for you, but in the interim you need to call support so that we can organise that blood test for you. And when you get the result, you will receive a text message through your phone to tell you to book an appointment. If you're feeling poorly, don't wait for that. Just get in touch with us again, yeah?",
"speaker": "Doctor"
},
{
"start": 658.42287,
"end": 658.95865,
"text": "Uh huh.",
"speaker": "Patient"
},
{
"start": 665.6073,
"end": 666.14848,
"text": "",
"speaker": "Patient"
},
{
"start": 671.83837,
"end": 673.08833,
"text": "OK. Can I",
"speaker": "Patient"
},
{
"start": 677.19509,
"end": 679.99844,
"text": "I will. How do I call to report?",
"speaker": "Patient"
},
{
"start": 680.24774,
"end": 689.36557,
"text": "Ohh, there's a number on your app, yeah? If you open up your app there's the number on there. It's an oh three hundred number, yeah? So just call that number.",
"speaker": "Doctor"
},
{
"start": 687.09887,
"end": 687.75601,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 689.36669,
"end": 690.59285,
"text": "I will find it, thank you.",
"speaker": "Patient"
},
{
"start": 690.38202,
"end": 693.0765,
"text": "Alright then. You take care. Bye now.",
"speaker": "Doctor"
},
{
"start": 693.12242,
"end": 694.29502,
"text": "Thank you, ciao.",
"speaker": "Patient"
},
{
"start": 694.19313,
"end": 695.35946,
"text": " Ciao, bye.",
"speaker": "Doctor"
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],
"doctor_utterances": "Hello? Hello, can you hear me? Yes, I can. Hi, I'm Dr. Jacob and welcome to Babylon. How are you doing? OK Peter, so just before we , is it alright if you could confirm your full name for me please? OK, and your date of birth? . And uh, and um, what's your email address? That's correct. And just to confirm that you're in a secure location, and we can have a confidential conversation. Alright. So, you've mentioned that you're not having much of an appetite and energy lately. I'm sorry to hear that. Could you tell me a bit more about it please? So, so you, are you telling me that your, your mood's low? Is that what you're trying to tell me? your mood, would you say you're depressed? it's a tough one isn't it? Because we don't want to actually say Uh do you like your work? Do you like your work? You like your work. OK. And um you, and how are things at home? Alright? Are you having any kind of stress at home? And have you lost any weight? OK, right. So you mentioned that you've lost your appetite for a while now. So how long are we talking about? We talking about two months, three months, or six months ? and a half months ago. But you said your weight loss is much longer than that? Sorry, could you , I couldn't hear you. What did you say, your weight loss, how long? at least six months, would you say? six months. And roughly how much have you lost? Just approximately. So about a stone, yeah? Six months, OK. OK. , OK. Right, OK. So, just a few more questions. It might seem a bit awkward, but it's quite relevant. OK? So, how are your bowels? Are they OK? Yeah, um, your bowels. How's your toilet? OK. So, you're not going to the toilet? you are going. Like, to be very more specific, you don't have any diarrhoea? OK, so there's blood in the poo no mucus nothing of that sort? Just now, you mentioned nausea. Have you been ever sick with it? OK, well just the nausea, OK. Is there any particular foods that make you nauseous? OK. So you can't think of any real.... Do you suffer from acid reflux? OK, OK. You also mentioned that you're feeling short of breath so yeah is there any cough? OK. Yeah. Is it like in closed spaces? So, how far can you walk and when you start feeling short of breath? So how far can you walk with no shortness of breath? Walk, you start with walk. Do you feel short of breathlet's start this way, do you feel short of uh breath when you walk at all? Right. You so you can walk about a mile and you don't feel short of breath at all. OK, so just explain a bit more just make myself clear about the lift thing. So you said you're short of breath when you're in the lift? described them like palpitations to me, yeah? So that's what you're, you're feeling your own heartbeat. Yeah, OK. You get any chest pains with it? OK. OK, no chest pains. OK. Alright. Fine. So, what we need to do, um, just before that, um, just a few more things. Uh, any any past medical history you'd like to share with me today? Sorry you had thyroid problems. Ohh yeah, underactive thyroid, yes. Yep. Yeah, you're taking thyroxine? Are you using it every day? Why is that? OK, so is that, so all these things are since you've stopped taking the thyroxine? When was your last blood test? OK, so you've not had a blood test. Right, OK. It could, you know, generally for you know for underactive thyroids what symptoms you've said um it's the opposite that usually happens, yeah. It's for overactive thyroid like you can feel a bit like the racing of your heart beat and all so I'm not quite clear on what picture we are having here. Yeah? I think a general set of bloods is a good , good start. So what we look at, because you're not, you're not having the umph, aren't you? You're like, you're just feeling a bit, you know low and things like that, right? Well, um, and weak and things like that. So we'll just do a general set of bloods. we look at things like anaemia, how your kidney functions are, your livers, all that, with vitamin levels, and your . OK. And uh, now after we get those set of bloods, we will find out if we can find anything in them. If that's all clear, then we would need to do a physical examination. OK? We would need to then go in and do . But there's nothing from what your history you've said that, that we urgently warrant a physical examination at this point in time. I think it's a good idea to start off with a blood test, and then take it from there. Obviously with palpitations or chest pain, if you get that's more of a medical emergency. You need to go to A and E for that. OK? If things change, you've mentioned now your bowels are fine, and you're not being sick. So if that's the case it's OK, but if your, you know, bowels change or you're being sick again, you need to get in touch with us. OK? Sorry? Could you repeat that? Mm-hmm. OK. So let's do all the blood tests first and we'll take it from there. OK? But you know, if you have any chest pains, or change in bowel habits, do get in touch with us. OK. Now what we need to do is now you need to ring up support. And I'll the form for you, but in the interim you need to call support so that we can organise that blood test for you. And when you get the result, you will receive a text message through your phone to tell you to book an appointment. If you're feeling poorly, don't wait for that. Just get in touch with us again, yeah? Ohh, there's a number on your app, yeah? If you open up your app there's the number on there. It's an oh three hundred number, yeah? So just call that number. Alright then. You take care. Bye now. Ciao, bye.",
"patient_utterances": "Hi, I can hear you. Can you hear me? Hello, I'm Peter. I'm, I'm doing OK, I guess. That's Peter Peterson. Um, I'm, I'm thirty five years old. That's gonna be difficult now. My email address is Peter dot Peterson at dot co dot UK I am. That's right, thank you very much. Ohh, that's right . Started long, long ago now. Uh, that have been feeling down and, and didn't really have yeah, energy. Um, my, my, my wife was starting to complain as well, uh in, in nightly activities. And um, I just felt like I, I needed to call you guys and needed to get some, some more information about what could be going on. Um, it's just that, yeah, nothing is like, feeling right and I feel out of place. And, and, it's, it's, yeah, just down . Um. Yes, and like I'm feeling short of breath, breath it's like always yeah, out of energy I would say, yes, definitely . Um. Are you, you never want to say that do you? I mean, I mean, work is OK. Um, I have trouble at work sometimes, having headaches, feeling nauseous. Um, uh I can do my work that's. that's OK . Again? Um, who likes to be a lawyer? Sorry, that was mean. Um Yes, of course I like, I like. Um, it is OK. Uh, sometimes, because I'm having a loss of appetite, I'm, uh, yeah I'm not eating very much, and . Um, other than that, it's, it's OK, yeah. I have, a little bit, yes. Uh, but, uh, but that's, that's Over, over long period now. It must have started when I When I changed over to the new law firm. Uh, I would say months ago. Uh, uh. Three months ago, three and a half months ago, that was. Yeah it stopped doing that, uh, yeah. It started a little bit earlier than that. I, I, I'm not sure, though, how it's gonna Uh. Something like that, yeah. Ohh gosh. I would say, less than a storm, something like that. Um, I feel nauseous every now and again. Uh, it, it's, it's coming up, uh, yeah, it's just every now and again not feeling very good. Uh, trying to eat something, but don't really want to. Uh. That's OK, I would say. Uh, I don't really have problems when going to the toilet, it's just painless. Yes. Yes. Uh, no. No diarrhoea. No,no . Uh. Uh, no, no, nothing. No, actually not. Uh, . Yeah I'm feeling not well, uh, in the, in the, in the bowel region, yeah. Nauseous. No, nothing. I do not, no. Um, no, not really just, just It's like when, when when I go into the lift, uh, it, it happens to be that, uh, I like, you know, my heart starts beating and I can't really breath, uh No, it happens every time. It happens very significantly in, in the lift or when I'm, when I'm Um. Walk or run. No, actually not. That's right, yes. Yeah, my heart starts beating. I, I feel like I can't breathe and, and, uh, it's, it's very difficult too. Uh yeah, two twenty nine. Uh, it's going, yeah just, just that you, you know, when, when you just feel unwell, and yeah, your heart starts beating. Yep Not really, no. It's just that I'm up. No chest pain. Uh, yes. I had too little activity of my thyroid, uh. Thyroid. Too little activity, yes. Um, yeah, yeah, yeah. Um, and in, in In view of that, I took thyroxine. Uh, not anymore. Uh, I have, I have not been taking it in the last, actually since I changed doctor, I would say. Ohh. That might be coinciding, I'm not sure about that. Uh, haven't taken one in a long time. Mm hmm OK. OK. yes. No problem. Uh huh Okay. OK. OK, I have, I haven't been walking lately at all. I haven't, yes. I haven't been walking lately at all so like, it's really hard for me to identify when I feel the shortness of breath. Uh, just wanted to add that into , because, um, I haven't been walking. I haven't been feeling good enough for a good at all. So, yep. Thank you. I will, yes. Uh huh. OK. Can I I will. How do I call to report? OK. I will find it, thank you. Thank you, ciao.",
"num_turns": 138,
"reference_note": "{\"day\": 3, \"consultation\": 3, \"presenting_complaint\": \"I don't have much appetite or energy lately\", \"note\": \"History : having lack of energy for the past 3 months \\nYou are also having loss of appetite \\nYou are lacking motivation \\nYou are complaining of breathlessness and some times associated with palpitations \\nThere is no chest pain \\nYou are not depressed or stressed \\nYour bowels are normal \\nYou feel nauseous most of the time \\nThere is no vomiting \\nYou are also experiencing some weight loss in the past 6 months about a stone \\nThere is no history of acid reflux \\nPast medical history: you suffer from underactive thyroid \\nMedications: you have not been using the thyroxine for a while since you changed practice . You do not remember the last time you had your last set of bloods\\nPlan: you have been advised to contact support to help you to organize your blood test. This will look at aneamia, thyoids, liver, kidney and vitamin levels \\nYou will need to book in for another appointment after you receive a text message from Babylon. \\nSafety netting: If you develop chest pain with the palpitations, change in bowel habits you will need to contact us urgently\\n\", \"highlights\": [\"loss of appetite\", \"breathlessness\", \"weight loss in the past 6 months about a stone\", \"underactive thyroid\"]}",
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"consultation_id": "day3_consultation04",
"dialogue": "[Patient] Hi.\n[Doctor] Hi, hello. I'm Doctor Jacob and welcome to Babylon. Hello. Hi. So just before we start, is it alright if you could confirm your name for me please?\n[Patient] Hi there.\n[Patient] get to my name \n[Doctor] . And your date of birth?\n[Patient] Fourteenth November nineteen ninety six.\n[Doctor] And your address for me please?\n[Patient] And twenty eight Great Road SW nineteen one EZ.\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] Thank you.\n[Doctor] OK. So you've mentioned in in our notes that you've got some tightness. If you'd like to tell me a bit more about it please.\n[Patient] Yeah about two to three days ago, I was running with a friend. And usually I can talk to her whilst I run, but I found myself actually short of breath. I'm not really sure of that when I'm walking. Um, but definitely um, if I'm walking briskly now. Um, and I've used my blue inhaler but to no avail. It hasn't really helped me.\n[Doctor] . OK.\n[Patient] Um, ohh yeah, so I'm having, I'm just wheezing a bit, and coughing and just generally a bit short of breath\n[Doctor] Wheezing and coughing, OK. And you've mentioned you're using the blue inhaler. So, how often are you using the blue inhaler?\n[Patient] Um, I think I'm just using that as and when I have symptoms.\n[Doctor] Yeah. So, um, at the moment you are having shortness of breath. So, are you using it every day at the moment?\n[Patient] Um, yeah, and morning or evening to kinda prevent it as well.\n[Doctor] OK, and um what, which colour? What's the name of your preventor?\n[Patient] Um, it's blue. Um, I think, in totality, I'm Salbutamol, Flanel Bactroban and Hydrocortisone that I'm taking as well.\n[Doctor] Yeah.\n[Doctor] OK. So could you repeat that? \n[Patient] Er, Cetraben and Hydrocortisone.\n[Doctor] And hydrocortisone. So you'd have eczema also, yeah?\n[Patient] What's that, sorry?\n[Doctor] You do have a history of eczema, ?\n[Patient] Em, my brother is asthmatic and my sister has eczema. Em, and I've got a few issues, um, that I think could be eczema as well.\n[Doctor] OK, right. So coming back to your, um, you know your shortness of breath. You've mentioned you're wheezy, and you're coughing. Are you bringing up any phlegm at all?\n[Patient] Um, no I don't, um, I'm not covering up much .\n[Doctor] OK, no sputum, OK. Right . And um, how are you using your, um, your ? So are you using it every day?\n[Patient] Um, I think I'm using that every day and the Salbutamol just like as and when\n[Doctor] So, how are you using the ? Is it twice a day?\n[Patient] Um, yes \n[Doctor] twice OK. And have you ever been admitted in hospital because your was so bad?\n[Patient] Um, no, I haven't.\n[Doctor] OK. Righty-ho. When was the last time you had an asthma attack?\n[Patient] Um, about three to four years ago.\n[Doctor] Three to four years ago. And what, what did the GP do at that time?\n[Patient] Um, just, um, encourage me to carry on using my inhalers as a preventative.\n[Doctor] OK. So you didn't have any oral steroids or antibiotics?\n[Patient] Not that I can remember.\n[Doctor] OK. Um, OK. Right, have you ever had oral steroids in the past?\n[Patient] Um, no.\n[Doctor] When was the last time you had an asthma review with our nurse?\n[Patient] Uh, about two years ago.\n[Doctor] OK. Two years ago. OK. But, your asthma was pretty under control till, till now, isn't it?\n[Patient] Uh, yes, just in the last two to three days .\n[Doctor] Yes. So do you do a peak flow meter at home? Peak flow reading? Where you blow into, you know Do you do that? No?\n[Patient] Um, just every now and then. I haven't done overlap since I've has symptoms.\n[Doctor] OK. So, what was what's your peak flow reading when you're good? Like normally peak flow reading.\n[Patient] Um\n[Patient] Um, I think \n[Doctor] OK. Let's see it's about, um, three eighty, yeah? Yeah? three . OK.\n[Patient] Yeah.\n[Doctor] Right. So that's your normal, yeah? Righty-ho, OK. So what we need\n[Patient] Mm-hmm.\n[Doctor] OK. Do you have any allergies at all?\n[Patient] Erm, I have a fever.\n[Doctor] Sorry, could you repeat that please?\n[Patient] Sorry, I have hay fever.\n[Doctor] OK. Now any allergies to medication?\n[Patient] Ohh no \n[Doctor] OK. So you're not allergic to anything? OK. So no allergies. OK, excellent. Righty-ho. So what we need to do that obviously we you haven't had an asthma check for sometime and it looks like you can be having a small, small exacerbation. So what, I would like you to be seen by one of our GP's in the next few days.\n[Patient] Mm-hmm.\n[Doctor] In the interim, what I'd like you to do is you can use your blue inhaler as and when. OK. You can use it maximum about every two to four, four hours, but if you're using it that often that means pretty much that, you know, your asthma is really bad. You can use it, but that's not ideal.\n[Patient] Mm-hmm.\n[Doctor] But uh, the brown your Clenil. The brown inhaler.\n[Patient] Yeah.\n[Doctor] You can up the dose. If you're using just three puffs twice a day, you can increase it to four puffs twice a day. Yeah. And while, this is to do while you're waiting to see us.\n[Patient] Mm-hmm.\n[Doctor] Now, I've mentioned, you know, you're doing you know, increase the, uh, Clenil to four puffs twice a day and you're using the asthma, you know, the blue inhalers every two to four hours.\n[Patient] OK.\n[Doctor] And your breathing is getting really worse, then you would need to take yourself to A and E. You shouldn't wait for our appointment. OK. So, when you'd opt to sneeze you, what we're going to do is we're gonna examine your chest, yeah.\n[Patient] Yeah.\n[Doctor] Make you do the peak flow reading. So depending on what we find, you might need some antibiotics and some steroids.\n[Patient] Yeah.\n[Doctor] But anyway, while you're at home, we're going to by increasing your Clenil, we are increasing your steroid intake anyway.\n[Patient] OK.\n[Doctor] So, yeah. So, any questions you wanted to ask me? \n[Patient] No, that's thanks.\n[Doctor] Yeah. So, book an call support, book an appointment to see and I will recommend that meet her face to face. In the interim, increase your brown inhaler to four puffs twice a day, and your salbutamol inhalers up to every two hourly. But, if you breathing's getting worse and you've not seen us, do take your puffs to A and E. All right?\n[Patient] Great, OK. Thank you so much for your time. Thank you. \n[Doctor] You're welcome. You take care then, bye, bye now, bye. Bye.",
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"text": "Hi, hello. I'm Doctor Jacob and welcome to Babylon. Hello. Hi. So just before we start, is it alright if you could confirm your name for me please?",
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"text": "That's correct. And just to confirm that you're in a secure location, and we can have a confidential conversation.",
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"text": "Yeah about two to three days ago, I was running with a friend. And usually I can talk to her whilst I run, but I found myself actually short of breath. I'm not really sure of that when I'm walking. Um, but definitely um, if I'm walking briskly now. Um, and I've used my blue inhaler but to no avail. It hasn't really helped me.",
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"text": "And your breathing is getting really worse, then you would need to take yourself to A and E. You shouldn't wait for our appointment. OK. So, when you'd opt to sneeze you, what we're going to do is we're gonna examine your chest, yeah.",
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"text": "OK.",
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"speaker": "Patient"
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{
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"text": "Yeah. So, book an call support, book an appointment to see and I will recommend that meet her face to face. In the interim, increase your brown inhaler to four puffs twice a day, and your salbutamol inhalers up to every two hourly. But, if you breathing's getting worse and you've not seen us, do take your puffs to A and E. All right?",
"speaker": "Doctor"
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{
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"text": "Great, OK. Thank you so much for your time. Thank you. ",
"speaker": "Patient"
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"text": " You're welcome. You take care then, bye, bye now, bye. Bye.",
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"doctor_utterances": "Hi, hello. I'm Doctor Jacob and welcome to Babylon. Hello. Hi. So just before we start, is it alright if you could confirm your name for me please? . And your date of birth? And your 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. OK. So you've mentioned in in our notes that you've got some tightness. If you'd like to tell me a bit more about it please. . OK. Wheezing and coughing, OK. And you've mentioned you're using the blue inhaler. So, how often are you using the blue inhaler? Yeah. So, um, at the moment you are having shortness of breath. So, are you using it every day at the moment? OK, and um what, which colour? What's the name of your preventor? Yeah. OK. So could you repeat that? And hydrocortisone. So you'd have eczema also, yeah? You do have a history of eczema, ? OK, right. So coming back to your, um, you know your shortness of breath. You've mentioned you're wheezy, and you're coughing. Are you bringing up any phlegm at all? OK, no sputum, OK. Right . And um, how are you using your, um, your ? So are you using it every day? So, how are you using the ? Is it twice a day? twice OK. And have you ever been admitted in hospital because your was so bad? OK. Righty-ho. When was the last time you had an asthma attack? Three to four years ago. And what, what did the GP do at that time? OK. So you didn't have any oral steroids or antibiotics? OK. Um, OK. Right, have you ever had oral steroids in the past? When was the last time you had an asthma review with our nurse? OK. Two years ago. OK. But, your asthma was pretty under control till, till now, isn't it? Yes. So do you do a peak flow meter at home? Peak flow reading? Where you blow into, you know Do you do that? No? OK. So, what was what's your peak flow reading when you're good? Like normally peak flow reading. OK. Let's see it's about, um, three eighty, yeah? Yeah? three . OK. Right. So that's your normal, yeah? Righty-ho, OK. So what we need OK. Do you have any allergies at all? Sorry, could you repeat that please? OK. Now any allergies to medication? OK. So you're not allergic to anything? OK. So no allergies. OK, excellent. Righty-ho. So what we need to do that obviously we you haven't had an asthma check for sometime and it looks like you can be having a small, small exacerbation. So what, I would like you to be seen by one of our GP's in the next few days. In the interim, what I'd like you to do is you can use your blue inhaler as and when. OK. You can use it maximum about every two to four, four hours, but if you're using it that often that means pretty much that, you know, your asthma is really bad. You can use it, but that's not ideal. But uh, the brown your Clenil. The brown inhaler. You can up the dose. If you're using just three puffs twice a day, you can increase it to four puffs twice a day. Yeah. And while, this is to do while you're waiting to see us. Now, I've mentioned, you know, you're doing you know, increase the, uh, Clenil to four puffs twice a day and you're using the asthma, you know, the blue inhalers every two to four hours. And your breathing is getting really worse, then you would need to take yourself to A and E. You shouldn't wait for our appointment. OK. So, when you'd opt to sneeze you, what we're going to do is we're gonna examine your chest, yeah. Make you do the peak flow reading. So depending on what we find, you might need some antibiotics and some steroids. But anyway, while you're at home, we're going to by increasing your Clenil, we are increasing your steroid intake anyway. So, yeah. So, any questions you wanted to ask me? Yeah. So, book an call support, book an appointment to see and I will recommend that meet her face to face. In the interim, increase your brown inhaler to four puffs twice a day, and your salbutamol inhalers up to every two hourly. But, if you breathing's getting worse and you've not seen us, do take your puffs to A and E. All right? You're welcome. You take care then, bye, bye now, bye. Bye.",
"patient_utterances": "Hi. Hi there. get to my name Fourteenth November nineteen ninety six. And twenty eight Great Road SW nineteen one EZ. Thank you. Yeah about two to three days ago, I was running with a friend. And usually I can talk to her whilst I run, but I found myself actually short of breath. I'm not really sure of that when I'm walking. Um, but definitely um, if I'm walking briskly now. Um, and I've used my blue inhaler but to no avail. It hasn't really helped me. Um, ohh yeah, so I'm having, I'm just wheezing a bit, and coughing and just generally a bit short of breath Um, I think I'm just using that as and when I have symptoms. Um, yeah, and morning or evening to kinda prevent it as well. Um, it's blue. Um, I think, in totality, I'm Salbutamol, Flanel Bactroban and Hydrocortisone that I'm taking as well. Er, Cetraben and Hydrocortisone. What's that, sorry? Em, my brother is asthmatic and my sister has eczema. Em, and I've got a few issues, um, that I think could be eczema as well. Um, no I don't, um, I'm not covering up much . Um, I think I'm using that every day and the Salbutamol just like as and when Um, yes Um, no, I haven't. Um, about three to four years ago. Um, just, um, encourage me to carry on using my inhalers as a preventative. Not that I can remember. Um, no. Uh, about two years ago. Uh, yes, just in the last two to three days . Um, just every now and then. I haven't done overlap since I've has symptoms. Um Um, I think Yeah. Mm-hmm. Erm, I have a fever. Sorry, I have hay fever. Ohh no Mm-hmm. Mm-hmm. Yeah. Mm-hmm. OK. Yeah. Yeah. OK. No, that's thanks. Great, OK. Thank you so much for your time. Thank you. ",
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"reference_note": "{\"day\": 3, \"consultation\": 4, \"presenting_complaint\": \"my chest feels very tight\", \"note\": \"History: Having breathlessness for 3-4 days \\nHaving to use the blue inhalers twice a day \\nYou normally use it only as and when \\nYou are also on the clenil and taking it everyday 2 puff twice a day \\nYou are having a cough but no sputum \\nThere is some wheezing \\nMedical history : you had asthma since your childhood\\nYou suffer from eczema . your last asthma attack was 3 years ago \\nYou have never needed anitibiotics or steroids \\nYou have never been hospitalized because of your asthma \\nYour normal peak flow reading is 380\\nYou don't have any allergies \\nMedication : you also use hydrocortisone and cetraban for eczema\\nPlan : you have been advised to increase you brown inhaler to 4 puffs twice daily and can use the blue inhalers upto every 2-4 hrs \\nYou will need your chest reviewed by a doctor in the next 2 days \\nIf you were to get increasingly breathless with the treatment that has been advised and not seen a doctor yet, please go to A & E\\n\", \"highlights\": [\"breathlessness\", \"asthma\", \"eczema\", \"peak flow reading is 380\"]}",
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"dialogue": "[Patient] Hello.\n[Doctor] Hello. Hi, I'm Doctor Jacob and welcome to Babylon. How are you doing?\n[Patient] I'm OK, thank you. Um, not feeling that great actually.\n[Doctor] Good. Alright. I can't see your face properly , just, yeah that's it. That's good. Thank you. So, I'm sorry to hear that. But just before we start, is it alright if you could confirm your name for me please?\n[Patient] \n[Patient] I'm Mary Jane Grey, um.\n[Doctor] Date of birth?\n[Patient] Date of birth, um nineteen eighty.\n[Doctor] \n[Doctor] OK. And your address for me please?\n[Patient] Um, I live on SW four zero NG.\n[Doctor] \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] Yeah.\n[Doctor] OK. So you've mentioned that you're feeling dizzy. , yes.\n[Patient] Yeah. Yeah, I'm feeling I'm, I'm yeah, I'm feeling very sick. It's probably because i'm feeling dizzy, um the the room is sort of spinning, um.\n[Doctor] \n[Patient] And I, I can't, I can't walk properly. Uh, well I can walk properly but not straight, um. and my ears are buzzing a bit. I'm just, they're feeling a bit off.\n[Doctor] Mm-hmm. OK, ear's buzzing. So when did it all start?\n[Patient] Started probably about two hours ago maybe. but I, I, um, I had a a similar sort of thing about a month ago, um But I didn't really think anything of it, 'cause it it settled quite quickly. Um, but this has been going for a bit more now.\n[Doctor] \n[Doctor] OK. So you said, you mentioned it started a few hours ago. So did it start? What were you doing?\n[Patient] \n[Patient] Um, I was just actually making my husband some breakfast, um. And I, yeah, I just suddenly felt very fuzzy and dizzy, um, and a bit shaky.\n[Doctor] OK. So you mentioned, like the room spinning around?\n[Patient] \n[Patient] Yep.\n[Doctor] OK. And is, how long does it last for? Or is it there now, continuously now?\n[Patient] Yeah it's, it's there, the whole time.\n[Doctor] So it's there now for the past two hours you'd say, yeah?\n[Patient] Yep.\n[Doctor] OK. Did you have any kind of viral illness in the recent past, past couple of weeks?\n[Patient] No.\n[Doctor] No cold, cough, nothing.\n[Patient] No, I've been pretty healthy I think, um, yeah.\n[Doctor] Yeah, OK. Um, you've mentioned that you have a, some ear buzzing kind of thing. Any kind of ear pain or ear discharge, anything like that?\n[Patient] No, nothing.\n[Doctor] OK. Do you have a temperature at all?\n[Patient] I don't think so, um.\n[Doctor] OK, right. You also mentioned that you can walk, but you're not walking straight. Why is that? Is it because\n[Patient] I think just 'cause the room feels like it's moving a bit. Um\n[Doctor] Feels like to move . That's why you're feeling like you're a bit unsteady, yeah?\n[Patient] I'll look .\n[Patient] My, my legs and arms and everything are working fine I just, I don't feel like I'm stable. My, the room is spinning.\n[Doctor] So there's no weakness of your arms and legs. OK.\n[Patient] No.\n[Doctor] K. Right. Um, so you mentioned you had something like this a month ago. So how, how, how long did that episode last for?\n[Patient] Probably only about five, ten minutes.\n[Doctor] OK, right. And do you have any problems hearing at the moment? Like, is it muffled or something?\n[Patient] No.\n[Patient] It's just a bit of a buzzy noise in my ears, but otherwise I can hear everything.\n[Doctor] OK. Righty-ho. OK. So, have you been physically sick?\n[Patient] No, but now I'm feeling very sick.\n[Doctor] Nausea, OK.\n[Doctor] Righty-ho. And, I don't have much information of your past medical history. So is there any medical conditions you'd like to tell me, surgical, medical conditions?\n[Patient] Um, I've had premature ovarian failure, um, and I've taken HRT.\n[Doctor] OK charting premature hearing failure. OK, and um any other medications at all?\n[Patient] No.\n[Doctor] OK, do you have any allergies at all?\n[Patient] No.\n[Doctor] OK. Right. OK so , talking to you today, um, in the , the most common um, you know, diagnosis we would you're suffering from at the moment is something called labyrinthitis. Yeah? OK, that's when your middle ear...there is something um, some inflammation going on there, and there is some imbalances in the crystals there in your middle ear. OK, so what the most important treatment is actually giving you some kind of middle ear stability so that you won't feel as if you're going around in a boat, kind of feeling. OK? So that's what we need to . Because to actually make you function a bit more, we'll start you on certain medications. I would still like you to be seen by one of our doctors to take a look inside your ears to just make sure. So this is like just symptomatic relief like you have a fever we just give paracetamol. So just to, you know, make you able to come and see one of the doctors and things like that. while you're with the doctors, we'd like to do your blood pressure, just examine your, you know, you know, how your walking and everything is. OK, while we're waiting, while you're waiting on seeing the doctor if you double up any weakness of your legs or arms or, or, you know, a sudden headache.\n[Patient] OK.\n[Doctor] Any of those symptoms, or you start being violently sick with it, then you know, you would need to take your to A and E.\n[Patient] OK.\n[Doctor] But if not, wait for the appointment for the doctor to examine you um and we'll take it from there. So i'll, i'll send the a prescription at cross pharmacy looks like it's the Lloyd pharmacy on our system. Is that correct?\n[Patient] Yeah.\n[Doctor] Yeah. So we'll send you across that prescription. Um, it's called , yeah? It's one tablet three times a day. So I'll give you about ten days worth. In the interim, obviously in the next few days, you'll get to see one of my doctors and we'll have to just take it from there.\n[Patient] OK, thank you so much.\n[Doctor] Any questions at all?\n[Patient] Um, can you take, do you need to take those tablets with food? Or can you just take them any time?\n[Doctor] It doesn't really matter, you can take it, because sometimes, you know, you get the symptoms as soon as you wake up, so probably you'll feel a bit sick to eat anything so might as well just take the tablets.\n[Patient] \n[Patient] OK, that's great. Thank you so much, that's so helpful.\n[Doctor] Just make sure you call support to book that appointment, OK?\n[Patient] I will, thank you very much.\n[Doctor] Bye bye now. Bye\n[Patient] ",
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{
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"doctor_utterances": "Hello. Hi, I'm Doctor Jacob and welcome to Babylon. How are you doing? Good. Alright. I can't see your face properly , just, yeah that's it. That's good. Thank you. So, I'm sorry to hear that. But just before we start, is it alright if you could confirm your name for me please? Date of birth? OK. And your 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. OK. So you've mentioned that you're feeling dizzy. , yes. Mm-hmm. OK, ear's buzzing. So when did it all start? OK. So you said, you mentioned it started a few hours ago. So did it start? What were you doing? OK. So you mentioned, like the room spinning around? OK. And is, how long does it last for? Or is it there now, continuously now? So it's there now for the past two hours you'd say, yeah? OK. Did you have any kind of viral illness in the recent past, past couple of weeks? No cold, cough, nothing. Yeah, OK. Um, you've mentioned that you have a, some ear buzzing kind of thing. Any kind of ear pain or ear discharge, anything like that? OK. Do you have a temperature at all? OK, right. You also mentioned that you can walk, but you're not walking straight. Why is that? Is it because Feels like to move . That's why you're feeling like you're a bit unsteady, yeah? So there's no weakness of your arms and legs. OK. K. Right. Um, so you mentioned you had something like this a month ago. So how, how, how long did that episode last for? OK, right. And do you have any problems hearing at the moment? Like, is it muffled or something? OK. Righty-ho. OK. So, have you been physically sick? Nausea, OK. Righty-ho. And, I don't have much information of your past medical history. So is there any medical conditions you'd like to tell me, surgical, medical conditions? OK charting premature hearing failure. OK, and um any other medications at all? OK, do you have any allergies at all? OK. Right. OK so , talking to you today, um, in the , the most common um, you know, diagnosis we would you're suffering from at the moment is something called labyrinthitis. Yeah? OK, that's when your middle ear...there is something um, some inflammation going on there, and there is some imbalances in the crystals there in your middle ear. OK, so what the most important treatment is actually giving you some kind of middle ear stability so that you won't feel as if you're going around in a boat, kind of feeling. OK? So that's what we need to . Because to actually make you function a bit more, we'll start you on certain medications. I would still like you to be seen by one of our doctors to take a look inside your ears to just make sure. So this is like just symptomatic relief like you have a fever we just give paracetamol. So just to, you know, make you able to come and see one of the doctors and things like that. while you're with the doctors, we'd like to do your blood pressure, just examine your, you know, you know, how your walking and everything is. OK, while we're waiting, while you're waiting on seeing the doctor if you double up any weakness of your legs or arms or, or, you know, a sudden headache. Any of those symptoms, or you start being violently sick with it, then you know, you would need to take your to A and E. But if not, wait for the appointment for the doctor to examine you um and we'll take it from there. So i'll, i'll send the a prescription at cross pharmacy looks like it's the Lloyd pharmacy on our system. Is that correct? Yeah. So we'll send you across that prescription. Um, it's called , yeah? It's one tablet three times a day. So I'll give you about ten days worth. In the interim, obviously in the next few days, you'll get to see one of my doctors and we'll have to just take it from there. Any questions at all? It doesn't really matter, you can take it, because sometimes, you know, you get the symptoms as soon as you wake up, so probably you'll feel a bit sick to eat anything so might as well just take the tablets. Just make sure you call support to book that appointment, OK? Bye bye now. Bye",
"patient_utterances": "Hello. I'm OK, thank you. Um, not feeling that great actually. I'm Mary Jane Grey, um. Date of birth, um nineteen eighty. Um, I live on SW four zero NG. Yeah. Yeah. Yeah, I'm feeling I'm, I'm yeah, I'm feeling very sick. It's probably because i'm feeling dizzy, um the the room is sort of spinning, um. And I, I can't, I can't walk properly. Uh, well I can walk properly but not straight, um. and my ears are buzzing a bit. I'm just, they're feeling a bit off. Started probably about two hours ago maybe. but I, I, um, I had a a similar sort of thing about a month ago, um But I didn't really think anything of it, 'cause it it settled quite quickly. Um, but this has been going for a bit more now. Um, I was just actually making my husband some breakfast, um. And I, yeah, I just suddenly felt very fuzzy and dizzy, um, and a bit shaky. Yep. Yeah it's, it's there, the whole time. Yep. No. No, I've been pretty healthy I think, um, yeah. No, nothing. I don't think so, um. I think just 'cause the room feels like it's moving a bit. Um I'll look . My, my legs and arms and everything are working fine I just, I don't feel like I'm stable. My, the room is spinning. No. Probably only about five, ten minutes. No. It's just a bit of a buzzy noise in my ears, but otherwise I can hear everything. No, but now I'm feeling very sick. Um, I've had premature ovarian failure, um, and I've taken HRT. No. No. OK. OK. Yeah. OK, thank you so much. Um, can you take, do you need to take those tablets with food? Or can you just take them any time? OK, that's great. Thank you so much, that's so helpful. I will, thank you very much. ",
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"reference_note": "{\"day\": 3, \"consultation\": 5, \"presenting_complaint\": \"I've been feeling dizzy\", \"note\": \"History : having dizziness for the past few hours \\nYou had sometime similar a month ago but only lasted 10 minutes \\nYou feel as though you are in a boat \\nThere is no recent viral illness \\nThere is a buzzing noise in your ears \\nThere is no hearing problems \\nNo ear discharge or ear pain \\nYou feel nauseous but not been sick \\nThere is no weakness of the arms and legs \\nPast medical history #\\nYou have premature ovarian failure and take HRT\\nThere is no allergies \\nPlan we will prescribe some stemitil for symptom relief . Most likely disgnosis is labrynthitis\\nIf you will need to book a pace to face appointment to have your ears checked . If you develop any weakness of arms and legs, vomiting . Please go to A & E\\n\", \"highlights\": [\"dizziness\", \"premature ovarian failure\", \"HRT\", \"labrynthitis\"]}",
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"dialogue": "[Doctor] Hello, hi, I'm Doctor Jacob and welcome to Babylon.\n[Patient] I have been\n[Doctor] You're right. So just before we start, is it alright if you could confirm your name for me, please?\n[Patient] Uh, not really.\n[Patient] My name is Jonathan Irving.\n[Doctor] And your date of birth?\n[Patient] Uh, six, twelve, uh, eighty.\n[Doctor] And your address for me, please.\n[Patient] Uh, sixty two Lewin Road Streatham SW sixteen six JT.\n[Doctor] correct, and just to confirm that you're in a secure location and we can have a confidential conversation.\n[Patient] Yes.\n[Doctor] Yeah. You've mentioned you had some breathing difficulties in the, the notes. How can I help you?\n[Patient] Yes, about fifteen minutes ago, I was gardening and, um, I was stung by wasp. Um, ran inside.\n[Doctor] Mm-hmm.\n[Patient] And now I'm, um, just starting to notice a few things. Yeah, I'm having quite shallow breath.\n[Doctor] You're having difficulties breathing since then, yeah?\n[Patient] \n[Doctor] OK. So, is there any swelling of your lips, you feel your throat is closing up?\n[Patient] Not throat, but I can , yeah, I can I can definitely feel something in the lips, yeah.\n[Doctor] Right, like a tingling kind of feeling?\n[Patient] Yes, yeah.\n[Doctor] OK, but no swelling, yeah?\n[Patient] Alright. I mean, you know, to be honest, I'm just doing this to establish whether I should go to the hospital.\n[Doctor] OK. Right, OK. Have you had anything like this before?\n[Patient] Uh, no.\n[Doctor] No. OK. So, um, do you feel wheezy in your chest, or just tightness?\n[Patient] Uh, yeah. Um, a bit of tightness. Yeah, a bit of tightness, yeah.\n[Doctor] Bit of tightness, OK, OK. So, I, unfortunately, I don't have much of your past medical history. Do you have any significant past medical or surgical history you'd like to share?\n[Patient] Uh, no, not really. Uh, a bit of eczema and I'm allergic to penicillin.\n[Doctor] OK. Are you on any regular medication at all?\n[Patient] \n[Doctor] OK. Righty-ho. Are you having any rash on your body at the moment?\n[Patient] Yes there's a bit of blotching .\n[Doctor] OK. Well, have you taken anything at all for the blotching?\n[Patient] I wouldn't even know what to take then.\n[Doctor] OK so you've, OK. That's fine. So from what you're saying, you do need to have medical attention straight away. OK? Um, do you have any antihistamines in your house at all?\n[Patient] Um, yes, I've used them for flying. I have aerosinusitis, so yes, I do \n[Doctor] So, why, why, and I'm, because your your breathing problem can get worse very quickly, I would like you to call. Is there someone else at home with you?\n[Patient] Yes, my wife can take me to the emergency room, yeah.\n[Doctor] Uh, no, I wouldn't want your wife to take you, I would like, I'd like her to call the ambulance because that might take a bit longer, and, you know, we need to deal with it quickly. So, what we are worried about is, you know, in case you develop an anaphylactic reaction.\n[Patient] \n[Patient] OK. She's listening. I'll get her to call now, yeah\n[Doctor] Yeah so, I'll ask her to give you the, um, antihistamine, in the meantime while the ambulance is coming. And take yourself to hospital. Um, it might just be an articularly reaction, but because you're complaining of breathing difficulties, it is quite important that you go to hospital straight away. But I'd like you to call the ambulance because, you know, so that you will be sorted out quickly.\n[Patient] OK.\n[Patient] Yeah. Alright, thank you. She's on it now. Yeah, she's on the phone.\n[Doctor] \n[Doctor] OK. Alright then, you take care.\n[Patient] Alright, thank you for the advice .\n[Doctor] ",
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"text": "Uh, no, not really. Uh, a bit of eczema and I'm allergic to penicillin.",
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"doctor_utterances": "Hello, hi, I'm Doctor Jacob and welcome to Babylon. You're right. So just before we start, is it alright if you could confirm your name for me, please? And your date of birth? And your address for me, please. correct, and just to confirm that you're in a secure location and we can have a confidential conversation. Yeah. You've mentioned you had some breathing difficulties in the, the notes. How can I help you? Mm-hmm. You're having difficulties breathing since then, yeah? OK. So, is there any swelling of your lips, you feel your throat is closing up? Right, like a tingling kind of feeling? OK, but no swelling, yeah? OK. Right, OK. Have you had anything like this before? No. OK. So, um, do you feel wheezy in your chest, or just tightness? Bit of tightness, OK, OK. So, I, unfortunately, I don't have much of your past medical history. Do you have any significant past medical or surgical history you'd like to share? OK. Are you on any regular medication at all? OK. Righty-ho. Are you having any rash on your body at the moment? OK. Well, have you taken anything at all for the blotching? OK so you've, OK. That's fine. So from what you're saying, you do need to have medical attention straight away. OK? Um, do you have any antihistamines in your house at all? So, why, why, and I'm, because your your breathing problem can get worse very quickly, I would like you to call. Is there someone else at home with you? Uh, no, I wouldn't want your wife to take you, I would like, I'd like her to call the ambulance because that might take a bit longer, and, you know, we need to deal with it quickly. So, what we are worried about is, you know, in case you develop an anaphylactic reaction. Yeah so, I'll ask her to give you the, um, antihistamine, in the meantime while the ambulance is coming. And take yourself to hospital. Um, it might just be an articularly reaction, but because you're complaining of breathing difficulties, it is quite important that you go to hospital straight away. But I'd like you to call the ambulance because, you know, so that you will be sorted out quickly. OK. Alright then, you take care. ",
"patient_utterances": "I have been Uh, not really. My name is Jonathan Irving. Uh, six, twelve, uh, eighty. Uh, sixty two Lewin Road Streatham SW sixteen six JT. Yes. Yes, about fifteen minutes ago, I was gardening and, um, I was stung by wasp. Um, ran inside. And now I'm, um, just starting to notice a few things. Yeah, I'm having quite shallow breath. Not throat, but I can , yeah, I can I can definitely feel something in the lips, yeah. Yes, yeah. Alright. I mean, you know, to be honest, I'm just doing this to establish whether I should go to the hospital. Uh, no. Uh, yeah. Um, a bit of tightness. Yeah, a bit of tightness, yeah. Uh, no, not really. Uh, a bit of eczema and I'm allergic to penicillin. Yes there's a bit of blotching . I wouldn't even know what to take then. Um, yes, I've used them for flying. I have aerosinusitis, so yes, I do Yes, my wife can take me to the emergency room, yeah. OK. She's listening. I'll get her to call now, yeah OK. Yeah. Alright, thank you. She's on it now. Yeah, she's on the phone. Alright, thank you for the advice .",
"num_turns": 49,
"reference_note": "{\"day\": 3, \"consultation\": 6, \"presenting_complaint\": \"I'm having difficulty breathing\", \"note\": \"History : breathing difficulty for past 20 minutes after being bitten by wasp \\nThere is some blotching rash seen \\ntingling feeling around your lips \\nno closing of the throat feeling \\nno previous similar history \\nPast medical history:\\nEczema \\nAllergic to penicillin\\nPlan : advised to start on antihistamines straight away. It might be just urticaria ( Hives)Call the ambulance to r/o possible anaphylactic reaction \\n\", \"highlights\": [\"Eczema\", \"Allergic to penicillin\", \"Hives\", \"anaphylactic reaction\"]}",
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"dialogue": "[Patient] Hello?\n[Doctor] Hi. Hi. My name is Doctor Jacob, and welcome to Babylon. How are you?\n[Patient] Thank you. I'm I'm I'm good. I mean I I'm uh, so, I'm bad.\n[Doctor] So. Your , OK. Right so just before we start, is it alright if you could confirm your name for me please?\n[Patient] \n[Doctor] And, your date of birth?\n[Patient] Seventeen of January, nineteen eighty seven.\n[Doctor] And your address for me, please.\n[Patient] Uh, sixty Hanover steps. Um\n[Doctor] That's good. And, just to confirm that you're in a secure location and we can have a confidential conversation.\n[Patient] London.\n[Patient] Yes.\n[Doctor] OK. So, you mentioned in our notes that you've got, um, skin problem. If you can tell me a bit more about it, please.\n[Patient] Yes, over the past few days I had uh, I've noticed my skin is uh, sore and red.\n[Doctor] OK. So where is it sore and red?\n[Patient] Um, it's uh, all over my chest, my hands and arms, and especially inside of the elbows. And, uh\n[Doctor] that.\n[Patient] on the, on the inside of the elbow.\n[Doctor] Elbows, OK. Inside of the elbows, yeah?\n[Patient] Which is the, the worst area.\n[Doctor] Alright, area. Is it very itchy?\n[Patient] It's very itchy and, uh, dry, all over my body\n[Doctor] Itchy and dry, OK. Have you had something like this in the past?\n[Patient] Yes, uh, if I haven't had \n[Doctor] OK. Do you think this is similar to your usual eczema, or is it worse?\n[Patient] Uh, I think it's, yeah, it's getting worse, like, the past few days. Way worse.\n[Doctor] Yeah. But you, could be like something similar. So on the skin is there any, you know any of the patches, sore and you mentioned it's quite sore. Is it weeping? Is it like watery liquid coming from that area? Weeping? \n[Patient] No. No.\n[Doctor] Nothing . OK. Right.\n[Patient] But, but, not the areas that are cracked.\n[Doctor] Yeah. So you have cracks over there, OK. And is there any scratch marks on your, on any of the, you know, areas, any scratch marks?\n[Patient] I mean uh, it's very itchy if I scratch myself, but there's no scratch mark.\n[Doctor] No. OK. Is there any thickened skin? Like, you know, where it's, the skin's very, um, thick, and darkened areas?\n[Patient] Mmm, no, no, I don't think, I don't think so.\n[Doctor] OK. Uh, righty-ho. So, you've mentioned you've, got a history of eczema, so what do you do about it? How do you keep it under control?\n[Patient] Yeah, usually I use a a a cream called diprobase. Uh, and in the shower I use something called dermal.\n[Doctor] \n[Doctor] Dermal, alright, and have you been using them recently, or not?\n[Patient] Yes. Yes, I, I use them.\n[Doctor] You use them every day?\n[Patient] Yes I, there there's no change in that. I didn't change any .\n[Doctor] OK. Have you ever used steroids in the past, for your eczema?\n[Patient] Um. I, I, I'm not sure. Uh, ah, yes, yes, yes, I remember now, I \n[Doctor] You've used steroids before?\n[Patient] Um, but it, it's not helping. \n[Doctor] Yeah. Also, you're still using the steroids.\n[Patient] Yeah, I tried. I tried.\n[Doctor] Which one are you using, the steroids? What's the name?\n[Patient] I'm not sure, it's uh, I would have the box is not there.\n[Doctor] , is it the ? OK. So, is it like the over-the-counter ones?\n[Patient] Sorry?\n[Doctor] Over the counter Hydrocortisone. That, does that ring a ? Yeah. So you're using the Hydrocortisone, yeah?\n[Patient] Yes.\n[Doctor] Are you using any antihistamines at all?\n[Patient] I No.\n[Doctor] No, no antihistamines. OK. Right, fine. Otherwise, other than those rash, you're feeling well in yourself. There's no temperature, no joint pains, yeah? No fever?\n[Patient] But, I remember that I've tried and it didn't work.\n[Doctor] You've tried the antihistamines and it didn't work. OK which one did you try?\n[Patient] The one over-the-counter.\n[Doctor] OK, so like cetirizine, yeah? Yeah, OK, that's fine. Right. OK, so from what you're describing, It looks like, you know, it is quite widespread, your eczema. Yeah? 'Cause you're having it all over your chest and hands and things like that. Um. So do you have any allergies to any medication at all?\n[Patient] Mm-hmm.\n[Patient] No, no allergies.\n[Doctor] No allergies, OK. And you don't, other than eczema you don't have any other medical condition.\n[Patient] I, I have asthma, and, uh, in my family, uh, there's hypothyroidism and migraine. My mother has migraine.\n[Doctor] Mother has migraine and, what was the other one, I didn't understand.\n[Patient] hypothyroidism.\n[Doctor] who who has hypothroidism?\n[Patient] My mother.\n[Doctor] OK. So, she has hyperthyroidism. OK. That's fine. Right here, you mentioned you have asthma. So, what medications are you using for asthma?\n[Patient] Um uh, you know, probably neither. Uh\n[Doctor] The blue inhaler? So you don't, you don't use it everyday, so you just use it on and off, yeah?\n[Patient] Yeah. Yeah.\n[Doctor] Blue inhalers. But your breathing's all OK, yeah?\n[Patient] OK, yeah, yeah. It's only when I have a flare. \n[Doctor] Yeah.\n[Doctor] Sure. So, what we need to do is, obviously, you've got , as I've mentioned. So, extensive eczema. What we'll do, we need a couple of minutes. Because to keep your a bit comfortable, we'll, you would probably need some antihistamines, which I'm going to prescribe. Also, hydrocortisone is a baby steroid that you use for young children. You might probably need a bit more stronger one, like betnovateor something like that. OK?\n[Patient] \n[Doctor] So we'll try that first. So I'm going to it's called the antihistamine is called Fexofenadine. And then we'll try with some Betnovate first. So it's like very small amount, like it's like one fingertip. Yeah. This much is, is enough to cover your palms. And your - back of your hands, yeah? So it's very small amounts, so that if you can imagine you can cover with a very small amount the whole body. Yeah. So use that. You, you have to use it twice a day, for the next couple of weeks. OK. If, if there's no improvement, you need to get back to us. Or, if you have any kind of adverse reaction, like an allergic reaction, which is unlikely, but if it still happens you need to get in touch with us. OK?\n[Patient] OK.\n[Patient] OK. Thank you very much.\n[Doctor] So, what we're going to do is, we're going to send off the prescription to your pharmacy. It looks like Boots on the systems, is that correct? Yeah? Yes, so i'll send it across to Boot's. And it will be there for collecting.\n[Patient] Yes.\n[Doctor] If things are getting worse in the next two weeks, call us before hand. Otherwise, wait for two weeks, take the medication and the cream. You still need to continue on your, emollients like the dermal soap, and, as well as the, diprovate. Yeah, so you still need to use those, in the interim. Any questions at all?\n[Patient] \n[Patient] No. No questions. Thank you. Thank you very\n[Doctor] OK then. You take care then. Bye bye now.\n[Patient] OK.\n[Doctor] Bye. Bye.",
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{
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"text": "Hi. Hi. My name is Doctor Jacob, and welcome to Babylon. How are you?",
"speaker": "Doctor"
},
{
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"text": "Thank you. I'm I'm I'm good. I mean I I'm uh, so, I'm bad.",
"speaker": "Patient"
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{
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"text": "So. Your , OK. Right so just before we start, is it alright if you could confirm your name for me please?",
"speaker": "Doctor"
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"text": "",
"speaker": "Patient"
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{
"start": 25.14495,
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"text": "And, your date of birth?",
"speaker": "Doctor"
},
{
"start": 27.63233,
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"text": "Seventeen of January, nineteen eighty seven.",
"speaker": "Patient"
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{
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"text": "And your address for me, please.",
"speaker": "Doctor"
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{
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"text": "Uh, sixty Hanover steps. Um",
"speaker": "Patient"
},
{
"start": 38.24078,
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"text": "That's good. And, just to confirm that you're in a secure location and we can have a confidential conversation.",
"speaker": "Doctor"
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{
"start": 38.49599,
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"text": "London.",
"speaker": "Patient"
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{
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"text": "Yes.",
"speaker": "Patient"
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{
"start": 46.12804,
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"text": "OK. So, you mentioned in our notes that you've got, um, skin problem. If you can tell me a bit more about it, please.",
"speaker": "Doctor"
},
{
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"text": "Yes, over the past few days I had uh, I've noticed my skin is uh, sore and red.",
"speaker": "Patient"
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{
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"text": "OK. So where is it sore and red?",
"speaker": "Doctor"
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"text": "Um, it's uh, all over my chest, my hands and arms, and especially inside of the elbows. And, uh",
"speaker": "Patient"
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{
"start": 71.88006,
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"text": " that.",
"speaker": "Doctor"
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{
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"text": " on the, on the inside of the elbow.",
"speaker": "Patient"
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{
"start": 76.27105,
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"text": "Elbows, OK. Inside of the elbows, yeah?",
"speaker": "Doctor"
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{
"start": 79.49179,
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"text": "Which is the, the worst area.",
"speaker": "Patient"
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{
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"text": "Alright, area. Is it very itchy?",
"speaker": "Doctor"
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"text": "It's very itchy and, uh, dry, all over my body",
"speaker": "Patient"
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{
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"text": "Itchy and dry, OK. Have you had something like this in the past?",
"speaker": "Doctor"
},
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"text": "Yes, uh, if I haven't had ",
"speaker": "Patient"
},
{
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"text": "OK. Do you think this is similar to your usual eczema, or is it worse?",
"speaker": "Doctor"
},
{
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"text": "Uh, I think it's, yeah, it's getting worse, like, the past few days. Way worse.",
"speaker": "Patient"
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{
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"text": "Yeah. But you, could be like something similar. So on the skin is there any, you know any of the patches, sore and you mentioned it's quite sore. Is it weeping? Is it like watery liquid coming from that area? Weeping? ",
"speaker": "Doctor"
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{
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"text": " No. No.",
"speaker": "Patient"
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"text": "Nothing . OK. Right.",
"speaker": "Doctor"
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"text": "But, but, not the areas that are cracked.",
"speaker": "Patient"
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"text": "Yeah. So you have cracks over there, OK. And is there any scratch marks on your, on any of the, you know, areas, any scratch marks?",
"speaker": "Doctor"
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{
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"text": "I mean uh, it's very itchy if I scratch myself, but there's no scratch mark.",
"speaker": "Patient"
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{
"start": 137.5646,
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"text": "No. OK. Is there any thickened skin? Like, you know, where it's, the skin's very, um, thick, and darkened areas?",
"speaker": "Doctor"
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{
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"text": "Mmm, no, no, I don't think, I don't think so.",
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"text": "OK. Uh, righty-ho. So, you've mentioned you've, got a history of eczema, so what do you do about it? How do you keep it under control?",
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"text": "Yeah, usually I use a a a cream called diprobase. Uh, and in the shower I use something called dermal.",
"speaker": "Patient"
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"speaker": "Doctor"
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"text": "Dermal, alright, and have you been using them recently, or not?",
"speaker": "Doctor"
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{
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"text": "Yes. Yes, I, I use them.",
"speaker": "Patient"
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"text": "You use them every day?",
"speaker": "Doctor"
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"text": "Yes I, there there's no change in that. I didn't change any .",
"speaker": "Patient"
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"text": " OK. Have you ever used steroids in the past, for your eczema?",
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"text": "Um. I, I, I'm not sure. Uh, ah, yes, yes, yes, I remember now, I ",
"speaker": "Patient"
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"text": " You've used steroids before?",
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"text": "Um, but it, it's not helping. ",
"speaker": "Patient"
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"text": " Yeah. Also, you're still using the steroids.",
"speaker": "Doctor"
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"text": "Yeah, I tried. I tried.",
"speaker": "Patient"
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"text": "Which one are you using, the steroids? What's the name?",
"speaker": "Doctor"
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"text": "I'm not sure, it's uh, I would have the box is not there.",
"speaker": "Patient"
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{
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"text": ", is it the ? OK. So, is it like the over-the-counter ones?",
"speaker": "Doctor"
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{
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"text": "Sorry?",
"speaker": "Patient"
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{
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"text": "Over the counter Hydrocortisone. That, does that ring a ? Yeah. So you're using the Hydrocortisone, yeah?",
"speaker": "Doctor"
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{
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"text": "Yes.",
"speaker": "Patient"
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{
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"text": "Are you using any antihistamines at all?",
"speaker": "Doctor"
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{
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"text": "I No.",
"speaker": "Patient"
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{
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"text": "No, no antihistamines. OK. Right, fine. Otherwise, other than those rash, you're feeling well in yourself. There's no temperature, no joint pains, yeah? No fever?",
"speaker": "Doctor"
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{
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"text": " But, I remember that I've tried and it didn't work.",
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{
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"text": "You've tried the antihistamines and it didn't work. OK which one did you try?",
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"text": "The one over-the-counter.",
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{
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"text": "OK, so like cetirizine, yeah? Yeah, OK, that's fine. Right. OK, so from what you're describing, It looks like, you know, it is quite widespread, your eczema. Yeah? 'Cause you're having it all over your chest and hands and things like that. Um. So do you have any allergies to any medication at all?",
"speaker": "Doctor"
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{
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"text": "Mm-hmm.",
"speaker": "Patient"
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"text": "No, no allergies.",
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"text": "No allergies, OK. And you don't, other than eczema you don't have any other medical condition.",
"speaker": "Doctor"
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{
"start": 292.41915,
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"text": "I, I have asthma, and, uh, in my family, uh, there's hypothyroidism and migraine. My mother has migraine.",
"speaker": "Patient"
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"text": " Mother has migraine and, what was the other one, I didn't understand.",
"speaker": "Doctor"
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"text": " hypothyroidism.",
"speaker": "Patient"
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{
"start": 305.20773,
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"text": " who who has hypothroidism?",
"speaker": "Doctor"
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"text": "My mother.",
"speaker": "Patient"
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"start": 309.58798,
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"text": "OK. So, she has hyperthyroidism. OK. That's fine. Right here, you mentioned you have asthma. So, what medications are you using for asthma?",
"speaker": "Doctor"
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{
"start": 319.71251,
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"text": "Um uh, you know, probably neither. Uh",
"speaker": "Patient"
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{
"start": 324.47528,
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"text": "The blue inhaler? So you don't, you don't use it everyday, so you just use it on and off, yeah?",
"speaker": "Doctor"
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"text": "Yeah. Yeah.",
"speaker": "Patient"
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{
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"text": "Blue inhalers. But your breathing's all OK, yeah?",
"speaker": "Doctor"
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"text": "OK, yeah, yeah. It's only when I have a flare. ",
"speaker": "Patient"
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{
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"text": "Yeah.",
"speaker": "Doctor"
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{
"start": 338.5806,
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"text": "Sure. So, what we need to do is, obviously, you've got , as I've mentioned. So, extensive eczema. What we'll do, we need a couple of minutes. Because to keep your a bit comfortable, we'll, you would probably need some antihistamines, which I'm going to prescribe. Also, hydrocortisone is a baby steroid that you use for young children. You might probably need a bit more stronger one, like betnovateor something like that. OK?",
"speaker": "Doctor"
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"start": 364.52137,
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"speaker": "Patient"
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{
"start": 365.04693,
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"text": "So we'll try that first. So I'm going to it's called the antihistamine is called Fexofenadine. And then we'll try with some Betnovate first. So it's like very small amount, like it's like one fingertip. Yeah. This much is, is enough to cover your palms. And your - back of your hands, yeah? So it's very small amounts, so that if you can imagine you can cover with a very small amount the whole body. Yeah. So use that. You, you have to use it twice a day, for the next couple of weeks. OK. If, if there's no improvement, you need to get back to us. Or, if you have any kind of adverse reaction, like an allergic reaction, which is unlikely, but if it still happens you need to get in touch with us. OK?",
"speaker": "Doctor"
},
{
"start": 397.50093,
"end": 398.14332,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 411.54324,
"end": 413.35254,
"text": "OK. Thank you very much.",
"speaker": "Patient"
},
{
"start": 411.96449,
"end": 428.37813,
"text": " So, what we're going to do is, we're going to send off the prescription to your pharmacy. It looks like Boots on the systems, is that correct? Yeah? Yes, so i'll send it across to Boot's. And it will be there for collecting.",
"speaker": "Doctor"
},
{
"start": 422.52429,
"end": 423.36084,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 428.37813,
"end": 449.21284,
"text": "If things are getting worse in the next two weeks, call us before hand. Otherwise, wait for two weeks, take the medication and the cream. You still need to continue on your, emollients like the dermal soap, and, as well as the, diprovate. Yeah, so you still need to use those, in the interim. Any questions at all?",
"speaker": "Doctor"
},
{
"start": 443.56404,
"end": 444.23503,
"text": "",
"speaker": "Patient"
},
{
"start": 450.55083,
"end": 452.90222,
"text": "No. No questions. Thank you. Thank you very",
"speaker": "Patient"
},
{
"start": 450.93465,
"end": 455.10343,
"text": "OK then. You take care then. Bye bye now.",
"speaker": "Doctor"
},
{
"start": 455.26848,
"end": 455.88437,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 455.58842,
"end": 456.75423,
"text": "Bye. Bye.",
"speaker": "Doctor"
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],
"doctor_utterances": "Hi. Hi. My name is Doctor Jacob, and welcome to Babylon. How are you? So. Your , OK. Right so just before we start, is it alright if you could confirm your name for me please? And, your date of birth? And your address for me, please. That's good. And, just to confirm that you're in a secure location and we can have a confidential conversation. OK. So, you mentioned in our notes that you've got, um, skin problem. If you can tell me a bit more about it, please. OK. So where is it sore and red? that. Elbows, OK. Inside of the elbows, yeah? Alright, area. Is it very itchy? Itchy and dry, OK. Have you had something like this in the past? OK. Do you think this is similar to your usual eczema, or is it worse? Yeah. But you, could be like something similar. So on the skin is there any, you know any of the patches, sore and you mentioned it's quite sore. Is it weeping? Is it like watery liquid coming from that area? Weeping? Nothing . OK. Right. Yeah. So you have cracks over there, OK. And is there any scratch marks on your, on any of the, you know, areas, any scratch marks? No. OK. Is there any thickened skin? Like, you know, where it's, the skin's very, um, thick, and darkened areas? OK. Uh, righty-ho. So, you've mentioned you've, got a history of eczema, so what do you do about it? How do you keep it under control? Dermal, alright, and have you been using them recently, or not? You use them every day? OK. Have you ever used steroids in the past, for your eczema? You've used steroids before? Yeah. Also, you're still using the steroids. Which one are you using, the steroids? What's the name? , is it the ? OK. So, is it like the over-the-counter ones? Over the counter Hydrocortisone. That, does that ring a ? Yeah. So you're using the Hydrocortisone, yeah? Are you using any antihistamines at all? No, no antihistamines. OK. Right, fine. Otherwise, other than those rash, you're feeling well in yourself. There's no temperature, no joint pains, yeah? No fever? You've tried the antihistamines and it didn't work. OK which one did you try? OK, so like cetirizine, yeah? Yeah, OK, that's fine. Right. OK, so from what you're describing, It looks like, you know, it is quite widespread, your eczema. Yeah? 'Cause you're having it all over your chest and hands and things like that. Um. So do you have any allergies to any medication at all? No allergies, OK. And you don't, other than eczema you don't have any other medical condition. Mother has migraine and, what was the other one, I didn't understand. who who has hypothroidism? OK. So, she has hyperthyroidism. OK. That's fine. Right here, you mentioned you have asthma. So, what medications are you using for asthma? The blue inhaler? So you don't, you don't use it everyday, so you just use it on and off, yeah? Blue inhalers. But your breathing's all OK, yeah? Yeah. Sure. So, what we need to do is, obviously, you've got , as I've mentioned. So, extensive eczema. What we'll do, we need a couple of minutes. Because to keep your a bit comfortable, we'll, you would probably need some antihistamines, which I'm going to prescribe. Also, hydrocortisone is a baby steroid that you use for young children. You might probably need a bit more stronger one, like betnovateor something like that. OK? So we'll try that first. So I'm going to it's called the antihistamine is called Fexofenadine. And then we'll try with some Betnovate first. So it's like very small amount, like it's like one fingertip. Yeah. This much is, is enough to cover your palms. And your - back of your hands, yeah? So it's very small amounts, so that if you can imagine you can cover with a very small amount the whole body. Yeah. So use that. You, you have to use it twice a day, for the next couple of weeks. OK. If, if there's no improvement, you need to get back to us. Or, if you have any kind of adverse reaction, like an allergic reaction, which is unlikely, but if it still happens you need to get in touch with us. OK? So, what we're going to do is, we're going to send off the prescription to your pharmacy. It looks like Boots on the systems, is that correct? Yeah? Yes, so i'll send it across to Boot's. And it will be there for collecting. If things are getting worse in the next two weeks, call us before hand. Otherwise, wait for two weeks, take the medication and the cream. You still need to continue on your, emollients like the dermal soap, and, as well as the, diprovate. Yeah, so you still need to use those, in the interim. Any questions at all? OK then. You take care then. Bye bye now. Bye. Bye.",
"patient_utterances": " Hello? Thank you. I'm I'm I'm good. I mean I I'm uh, so, I'm bad. Seventeen of January, nineteen eighty seven. Uh, sixty Hanover steps. Um London. Yes. Yes, over the past few days I had uh, I've noticed my skin is uh, sore and red. Um, it's uh, all over my chest, my hands and arms, and especially inside of the elbows. And, uh on the, on the inside of the elbow. Which is the, the worst area. It's very itchy and, uh, dry, all over my body Yes, uh, if I haven't had Uh, I think it's, yeah, it's getting worse, like, the past few days. Way worse. No. No. But, but, not the areas that are cracked. I mean uh, it's very itchy if I scratch myself, but there's no scratch mark. Mmm, no, no, I don't think, I don't think so. Yeah, usually I use a a a cream called diprobase. Uh, and in the shower I use something called dermal. Yes. Yes, I, I use them. Yes I, there there's no change in that. I didn't change any . Um. I, I, I'm not sure. Uh, ah, yes, yes, yes, I remember now, I Um, but it, it's not helping. Yeah, I tried. I tried. I'm not sure, it's uh, I would have the box is not there. Sorry? Yes. I No. But, I remember that I've tried and it didn't work. The one over-the-counter. Mm-hmm. No, no allergies. I, I have asthma, and, uh, in my family, uh, there's hypothyroidism and migraine. My mother has migraine. hypothyroidism. My mother. Um uh, you know, probably neither. Uh Yeah. Yeah. OK, yeah, yeah. It's only when I have a flare. OK. OK. Thank you very much. Yes. No. No questions. Thank you. Thank you very OK.",
"num_turns": 88,
"reference_note": "{\"day\": 3, \"consultation\": 7, \"presenting_complaint\": \"I have sore red skin\", \"note\": \"History : \\nRed sore rash for the past few days \\nAll over the chest hands and arms \\nWorse especially in the inside of the arms \\nThere is no scratch marks \\nNo thickened skin\\nRash is dry and itchy\\nNo fever and joint pains\\nUsed hydrocortisone and cetirizine not better\\nPMH : asthma , eczema\\nMedication: diprobase, dermol , hydrocortisone, salbutamol\\nFH Hypothyroidism \\nNo allergies \\nPlan : advised will prescribe fexofenatidine and Betnovate for eczema. Need to use steroid cream sparingly . Explained one finger tip enough to cover the palms and back of your hands. \\nIf your symptoms are getting worse or there is an allergic reaction please speak with doctor urgently. If your symptoms are not better in the next 2 weeks please book another appointment with the doctor.\\n\", \"highlights\": [\"asthma\", \"eczema\", \"FH Hypothyroidism\", \"No allergies\"]}",
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"dialogue": "[Doctor] Hello?\n[Patient] Hi there!\n[Doctor] Hi, hi, I'm doctor Jacob and welcome to Babylon. Hello.\n[Patient] I, uh\n[Doctor] Hi. So just before we start, is it alright if you could confirm your full name for me please?\n[Patient] Uh, , that's, uh, John Jones.\n[Doctor] \n[Doctor] And your date of birth.\n[Patient] Uh, that's, uh, the, twenty ninth of September, nineteen eighty.\n[Doctor] K. And your email address for me please?\n[Patient] Uh, that's, uh, John Jones, at, John Jones dot net.\n[Doctor] OK. And just to confirm that you're in a secure location, and we can have a confidential conversation.\n[Patient] Yep. That's absolutely fine.\n[Doctor] OK. So, you've mentioned on our notes that you're having a bit of a cough and a cold. Is that correct?\n[Patient] Yeah, yeah, it's just it's been going on for, like a few days now. Um, sort of like, coughing, and like, general runny nose, and stuff, and, like \n[Doctor] is it two to three days, or longer?\n[Patient] Little bit, uh about like five days around that, uh, yeah it started like, what day is it today? Uh, yeah the week, it started with the start of the weekend, so.\n[Doctor] Fine.\n[Doctor] OK. So, so it started off with a cold, did it?\n[Patient] Yeah just like coughing, and like running nose, and like kind of muscles aching and stuff, like occasional feeling like headache, cold, chills, and things like that.\n[Doctor] \n[Doctor] OK. Important cold, yeah? And, so about your cough, are you bringing up any phlegm at all?\n[Patient] Yeah.\n[Patient] No, no, it's like a, it's like a dry cough Sort of like like, almost hacking, hacking kind of like .\n[Doctor] OK. You're not bringing up any blood, are you?\n[Patient] \n[Doctor] OK. Are you feeling short of breath at all?\n[Patient] No, no, no shortness , like yeah, I'm breathing fine.\n[Doctor] Yeah. So you're not wheezy or rattly noises in your chest.\n[Patient] No.\n[Doctor] OK. Um, right. So what have you taken so far?\n[Patient] Uh, so, uh, just like pain killers and such. I mean that I, I, um, in addition to like my normal medication and such. Um, but like\n[Doctor] Well you mentioned, uh, you've come to your normal medications but you've mentioned you've taken some painkillers like, would you tell me the names please?\n[Patient] I'll just like pass it along.\n[Doctor] Paracetamol, OK. Any Ibuprofen at all?\n[Patient] No\n[Doctor] No, OK. And also um you mentioned some regular medication. Unfortunately I don't have your medical, complete medical history. So if you could tell me what your medications are, and what you use them for?\n[Patient] Yeah, so I take, um, uh, what's it called, it's like metformin. I'm a diabetic, so. And, um, I also, like have, uh, lisinopril .\n[Doctor] Lisonopril, OK.\n[Patient] Yeah, but the like slight blood pressure.\n[Doctor] Yeah, OK. And, how long have you been a diabetic for?\n[Patient] Um, like a, a few years, maybe five or six years.\n[Doctor] Five six years, OK. OK. Do you monitor your blood sugars at home?\n[Patient] Yes.\n[Doctor] OK. And how have they been doing at the moment?\n[Patient] Uh, no issues nothing like out of the ordinary there.\n[Doctor] OK. So there's no problems with your blood pressure control at the moment, even though you're not, OK so that's fine. That's absolutely fine. And when was the last time you took your blood pressure?\n[Patient] Uh, I've been this morning.\n[Doctor] This morning. And what was it? What was the readings like?\n[Patient] I can't remember off the top of my head, but it was within the normal range.\n[Doctor] Cool, 'cause there's nothing alarming yeah? No more. OK. That's fine. OK. So that seems all right. OK. So, um, can I, hypothetically, look into your mouth here?\n[Patient] Sure.\n[Doctor] Yeah? Yeah, so, uh, looking into your mouth\n[Patient] \n[Doctor] Um, you know, there's just a bit mild redness at the back of your throat. Um, there's no enlarged tonsils. Can you feel any glands around your neck, at all? No. No.\n[Patient] No, I haven't had anything like that.\n[Doctor] OK. So, it looks like, it's just a viral infection. Um, because it's just a cold and a cough. There's nothing there. And generally if you have things like a chest infection, you would have a bit like a wheeze or shortness of breath. So, um, things that we would recommend is you can use the, you know, Night Nurse, Day Nurse. It's still OK with your medications, yeah. So I'm, I'm sure that you are a bit wary to use them. But it's still OK with your current medication. You can still use that. Might be able to make you feel a bit more better quickly.\n[Patient] OK.\n[Doctor] If there's any change, like you're feeling short of breath or be your symptoms are lasting more than three weeks or something Or you're becoming poorly, uh, things like that, then you need to get in touch with us, then probably we might need to examine you and especially your chest. But I don't think so, that's necessary at this point in time\n[Patient] OK, that sounds good.\n[Doctor] OK. Any questions at all ?\n[Patient] Uh, no, I I think that's been very helpful thank you.\n[Doctor] OK. So just to round up, just use the night, Night Nurse, Day Nurse, if any change in your symptoms, like shortness of breath, wheezy, or symptoms are lasting more than three weeks, then get in touch with us.\n[Patient] OK, so I don't need any prescription, or anything like that.\n[Doctor] No, no you don't need anything at the moment. OK. Take care, then. Bye. Bye bye.\n[Patient] OK. Thank you very much, bye!",
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"text": "Uh, no, I I think that's been very helpful thank you.",
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"text": "OK. So just to round up, just use the night, Night Nurse, Day Nurse, if any change in your symptoms, like shortness of breath, wheezy, or symptoms are lasting more than three weeks, then get in touch with us.",
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"text": "No, no you don't need anything at the moment. OK. Take care, then. Bye. Bye bye.",
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"doctor_utterances": "Hello? Hi, hi, I'm doctor Jacob and welcome to Babylon. Hello. Hi. So just before we start, is it alright if you could confirm your full name for me please? And your date of birth. K. And your email address for me please? OK. And just to confirm that you're in a secure location, and we can have a confidential conversation. OK. So, you've mentioned on our notes that you're having a bit of a cough and a cold. Is that correct? is it two to three days, or longer? Fine. OK. So, so it started off with a cold, did it? OK. Important cold, yeah? And, so about your cough, are you bringing up any phlegm at all? OK. You're not bringing up any blood, are you? OK. Are you feeling short of breath at all? Yeah. So you're not wheezy or rattly noises in your chest. OK. Um, right. So what have you taken so far? Well you mentioned, uh, you've come to your normal medications but you've mentioned you've taken some painkillers like, would you tell me the names please? Paracetamol, OK. Any Ibuprofen at all? No, OK. And also um you mentioned some regular medication. Unfortunately I don't have your medical, complete medical history. So if you could tell me what your medications are, and what you use them for? Lisonopril, OK. Yeah, OK. And, how long have you been a diabetic for? Five six years, OK. OK. Do you monitor your blood sugars at home? OK. And how have they been doing at the moment? OK. So there's no problems with your blood pressure control at the moment, even though you're not, OK so that's fine. That's absolutely fine. And when was the last time you took your blood pressure? This morning. And what was it? What was the readings like? Cool, 'cause there's nothing alarming yeah? No more. OK. That's fine. OK. So that seems all right. OK. So, um, can I, hypothetically, look into your mouth here? Yeah? Yeah, so, uh, looking into your mouth Um, you know, there's just a bit mild redness at the back of your throat. Um, there's no enlarged tonsils. Can you feel any glands around your neck, at all? No. No. OK. So, it looks like, it's just a viral infection. Um, because it's just a cold and a cough. There's nothing there. And generally if you have things like a chest infection, you would have a bit like a wheeze or shortness of breath. So, um, things that we would recommend is you can use the, you know, Night Nurse, Day Nurse. It's still OK with your medications, yeah. So I'm, I'm sure that you are a bit wary to use them. But it's still OK with your current medication. You can still use that. Might be able to make you feel a bit more better quickly. If there's any change, like you're feeling short of breath or be your symptoms are lasting more than three weeks or something Or you're becoming poorly, uh, things like that, then you need to get in touch with us, then probably we might need to examine you and especially your chest. But I don't think so, that's necessary at this point in time OK. Any questions at all ? OK. So just to round up, just use the night, Night Nurse, Day Nurse, if any change in your symptoms, like shortness of breath, wheezy, or symptoms are lasting more than three weeks, then get in touch with us. No, no you don't need anything at the moment. OK. Take care, then. Bye. Bye bye.",
"patient_utterances": "Hi there! I, uh Uh, , that's, uh, John Jones. Uh, that's, uh, the, twenty ninth of September, nineteen eighty. Uh, that's, uh, John Jones, at, John Jones dot net. Yep. That's absolutely fine. Yeah, yeah, it's just it's been going on for, like a few days now. Um, sort of like, coughing, and like, general runny nose, and stuff, and, like Little bit, uh about like five days around that, uh, yeah it started like, what day is it today? Uh, yeah the week, it started with the start of the weekend, so. Yeah just like coughing, and like running nose, and like kind of muscles aching and stuff, like occasional feeling like headache, cold, chills, and things like that. Yeah. No, no, it's like a, it's like a dry cough Sort of like like, almost hacking, hacking kind of like . No, no, no shortness , like yeah, I'm breathing fine. No. Uh, so, uh, just like pain killers and such. I mean that I, I, um, in addition to like my normal medication and such. Um, but like I'll just like pass it along. No Yeah, so I take, um, uh, what's it called, it's like metformin. I'm a diabetic, so. And, um, I also, like have, uh, lisinopril . Yeah, but the like slight blood pressure. Um, like a, a few years, maybe five or six years. Yes. Uh, no issues nothing like out of the ordinary there. Uh, I've been this morning. I can't remember off the top of my head, but it was within the normal range. Sure. No, I haven't had anything like that. OK. OK, that sounds good. Uh, no, I I think that's been very helpful thank you. OK, so I don't need any prescription, or anything like that. OK. Thank you very much, bye!",
"num_turns": 66,
"reference_note": "{\"day\": 3, \"consultation\": 8, \"presenting_complaint\": \"I have a cough and a cold\", \"note\": \"History : \\nCough and cold for 5 days \\nCough is dry, no sputum , no blood\\nNo wheeze \\nNo breathlessness \\nUsed paracetamol \\nDiabetic and high blood pressure since 5-6 years\\nMedication: metformin, lisinopril\\nSugar levels and BP normal today \\nDiagnosis: Upper respiratory tract infection\\nPlan : . advised to use night and day nurse. If there is breathlessness, wheezying or cough more than 3 weeks to call back\\n\", \"highlights\": [\"Sugar levels and BP normal today\", \"Upper respiratory tract infection\"]}",
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"dialogue": "[Patient] Hello.\n[Doctor] Hello, hi, I'm Doctor Jacob and welcome to Babylon. Hello.\n[Patient] Nice to meet you.\n[Doctor] Nice to meet you too. So just before we start, is it all right if you could confirm your name for me please?\n[Patient] Michael John .\n[Doctor] And your date of birth?\n[Patient] Oh nine two nine eighty-three.\n[Doctor] OK, and your address for me please.\n[Patient] Two three one, Leonard, London street uh, sorry, London.\n[Doctor] OK and that's correct, and just to confirm that you're in a secure location and we can have a confidential conversation.\n[Patient] Yes.\n[Doctor] OK, uh, you've mentioned on our notes that you're suffering from bad diarrhea. I'm sorry to hear about it. So if you tell me a bit more about it, please.\n[Patient] Uh, it's been happening for about, three days now? Um, yeah it, started off uh, was, I don't know it's just something that I thought would go away pretty quickly.\n[Doctor] OK.\n[Doctor] \n[Patient] I've had that from time to time after eating certain types of food or going on certain travels, but, uh nothing funky in my diet and no travels recently, um and it just kinda kept up. I'm a bit confused as to what to do .\n[Doctor] Mmm.\n[Doctor] Mm-hmm.\n[Doctor] So you haven't had anything from outside? Nothing dodgy anything ? No.\n[Patient] No, no no no, just a little bit, yeah I I don't know I mean it's pretty standard diarrhoea, where it's was like a little bit of abdominal pain. I threw up once, that was a little worrying, uh.\n[Doctor] \n[Doctor] Mm-hmm.\n[Doctor] Repeat that please, that wasn't clear. What did you say?\n[Patient] I threw up once, yeah.\n[Doctor] After that we'd said something.\n[Patient] Uh, nothing else was worrisome.\n[Doctor] OK, right, and with the diarrhea, how many times a day are you going to the toilet?\n[Patient] Uh, four to five.\n[Doctor] Four to five times, yeah. And is there any? And it's like water? Is it like water or is it just loose?\n[Patient] Uh, what do you mean?\n[Doctor] Are you going like water? Or is it just, you know bit, bit of solid stools, bit loose kind of thing?\n[Patient] It probably depends on the time of day to be honest, .\n[Doctor] Sure OK. Bit of both and is there any blood or mucus?\n[Patient] No blood. What do you mean mucus?\n[Doctor] It's like the snotty stuff.\n[Patient] In the stool?\n[Doctor] Yeah, it looks like snot .\n[Patient] No.\n[Doctor] No, so no mucus, OK. Any fever at all?\n[Patient] Uh, maybe a little bit, but.\n[Doctor] Mm-hmm.\n[Patient] It hasn't been, that in particular hasn't been too worrying.\n[Doctor] Are you still able to eat, and drink?\n[Patient] Uh, a little bit of. Appetite loss I guess worse than normal, but also not something I've, like I, if that was alone I wouldn't have, reached out.\n[Doctor] OK.\n[Doctor] Sure. So but you're you're still able to drink quite a bit yeah? You're drinking plenty.\n[Patient] Yeah yeah yeah.\n[Doctor] OK. Excellent.\n[Patient] Mostly it's been dry and red.\n[Doctor] OK, and, um, what have you take, have you taken anything so far for the diarrhea?\n[Patient] Nothing yet.\n[Doctor] Nothing yet, OK. Anything for the abdominal pain?\n[Patient] Uh, nothing yet.\n[Doctor] OK. Right, and any unfortunately we don't have any of your past medical history, is there anything you'd like to say?\n[Patient] Uh, I.\n[Patient] Probably I I had asthma.\n[Doctor] Mm-hmm.\n[Patient] Um or, or I don't know I guess I still have it.\n[Doctor] OK and uh, are you, any, uh, anything else other than asthma?\n[Patient] Uh, my dad had hypertension.\n[Doctor] OK.\n[Patient] Has hypertension. Had hypertension. Yeah he died of bowel cancer ten years ago.\n[Doctor] Yeah .\n[Doctor] Ohh dear, OK. Bowel cancer. Ten years ago. And how old was he when he died?\n[Patient] Uh, sixty-two.\n[Doctor] K, and um, you mentioned you had asthma, are you using any inhalers at all?\n[Patient] Yes.\n[Doctor] Which ones?\n[Patient] Lexapro.\n[Doctor] Sorry?\n[Patient] Lexapro.\n[Doctor] Laxepro.\n[Patient] Yes.\n[Doctor] OK, not heard of it may. Is it like Salbutamol? Is it like a blue colour?\n[Patient] Yellow.\n[Doctor] Yellow, OK. I'll have to check that one, not sure. Laxepro.\n[Doctor] OK. Um, that's fine. Any other medication that you're using? Over the counter, anything at all? OK. Right. Any allergies?\n[Patient] No.\n[Patient] Nothing, yeah, nothing.\n[Doctor] No allergies at all, righty . Fine so, obviously, you know you just have diarrhea it's about four to five times a day. Um, you're still drinking plenty and you look like you're not dehydrated which is a good sign, OK? Um, when we start worrying about diarrhea is if you're going more than eight times a day. That means probably you are, you know, whatever you're eating is going straight through, OK? You still need to drink plenty of water because you're losing a lot of fluids.\n[Patient] Mmm.\n[Doctor] OK, when you go to the toilet. Um, things that one would advise is a soft diet. So avoid dairy, fish, meat, eggs, while you're having the diarrhea. Go, sorry?\n[Patient] Soft . What is a soft diet? What does that ? Like, outside of, not those things, what do you mean by soft?\n[Doctor] OK, so that will be like crackers, toast, jam, those kind of things that's easily digested. Like what we are good give babies yeah. When they start eating you give, simple food for babies. You don't give eggs or meat the first time they start feeding. So that's the kind of soft diet we're talking about, yeah? Once you are able to, you know keep most of it in, you can start off with some just boiled vegetables and mash. Once you're OK with that for about forty-eight hours then you can start having meat. So just don't have meat once you feel like you're slightly better, because you might go back to square one again, all right?\n[Patient] \n[Patient] What do you mean OK with that diet, like once?\n[Doctor] Forty-eight hours you're not having any diarrhea, you're fine then you can go and start having meat, egg, fish and all. So that .\n[Patient] OK, if if the diarrhoea is getting better but isn't getting, or do you want it to go away completely at that point, or if it's like trending upwards?\n[Doctor] No, no, no preferably just don't because, what why do we say this? It's because it takes much more time for meat to get digested. So because your gut flora, you know, the, the, the bacteria in your gut is not you know as it should be, it takes a bit more effort for one to digest these food. While it doesn't take that much of an effort to, you know digest mash and vegetables. Does that make sense?\n[Patient] Yes.\n[Doctor] Yeah? So, um, at the same time you could have some, although you can't milk is not a good idea, yoghurts are a good idea because they are probiotics, it help to build up the normal, um gut, gut bacteria back. OK.\n[Patient] OK.\n[Doctor] So those kinda, now, things to look out for, if your diarrhoea doesn't go away in a week's time, or if you're passing blood, we need a stool sample, because that means you you may have , um, some particular bugs that might need treatment with antibiotics.\n[Patient] OK.\n[Doctor] OK. If you're again, as I've mentioned previously if you're going about six to eight times a day, that means there's a high chance that, uh, you are, having dehydration and you might need to go into hospital at that point in time. If that happens you get in touch with us again, all right?\n[Patient] OK.\n[Doctor] Any questions? You look a bit confused.\n[Patient] No, that's it.\n[Doctor] Yeah? OK and also you could get something called Dioralyte over the counter. So, it helps to uh, replenish your, the salts that you've been, that's lost through going to the toilet.\n[Patient] OK.\n[Doctor] OK? If you're a bit confused you know you can actually, uh, all this is all recorded in your app. So you can go back. I'll put that all in detail so if, you know I know sometimes it's a bit difficult to process everything, you can go back and read, read the notes.\n[Patient] Perfect, that's great.\n[Doctor] Is that OK? All right then, you take care.\n[Patient] Bye.\n[Doctor] Bye now, bye bye.",
"turns": [
{
"start": 2.02135,
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"text": "Hello.",
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{
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"text": "Hello, hi, I'm Doctor Jacob and welcome to Babylon. Hello.",
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"text": "Nice to meet you.",
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"text": " Nice to meet you too. So just before we start, is it all right if you could confirm your name for me please?",
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"text": "Michael John .",
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"text": "And your date of birth?",
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"text": "OK, and your address for me please.",
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"text": "Two three one, Leonard, London street uh, sorry, London.",
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"text": "OK and that's correct, and just to confirm that you're in a secure location and we can have a confidential conversation.",
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"text": "Yes.",
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"text": "OK, uh, you've mentioned on our notes that you're suffering from bad diarrhea. I'm sorry to hear about it. So if you tell me a bit more about it, please.",
"speaker": "Doctor"
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{
"start": 49.20109,
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"text": "Uh, it's been happening for about, three days now? Um, yeah it, started off uh, was, I don't know it's just something that I thought would go away pretty quickly.",
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"text": " I've had that from time to time after eating certain types of food or going on certain travels, but, uh nothing funky in my diet and no travels recently, um and it just kinda kept up. I'm a bit confused as to what to do .",
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"text": "Mm-hmm.",
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"text": "So you haven't had anything from outside? Nothing dodgy anything ? No.",
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"text": "No, no no no, just a little bit, yeah I I don't know I mean it's pretty standard diarrhoea, where it's was like a little bit of abdominal pain. I threw up once, that was a little worrying, uh.",
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"text": "OK, right, and with the diarrhea, how many times a day are you going to the toilet?",
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"text": "Uh, four to five.",
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"text": "Uh, maybe a little bit, but.",
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"text": "It hasn't been, that in particular hasn't been too worrying.",
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"text": "Uh, a little bit of. Appetite loss I guess worse than normal, but also not something I've, like I, if that was alone I wouldn't have, reached out.",
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"text": "Sure. So but you're you're still able to drink quite a bit yeah? You're drinking plenty.",
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"text": "OK, and, um, what have you take, have you taken anything so far for the diarrhea?",
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"text": "OK. Right, and any unfortunately we don't have any of your past medical history, is there anything you'd like to say?",
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"text": "Uh, I.",
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"text": "Probably I I had asthma.",
"speaker": "Patient"
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"text": "Mm-hmm.",
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"text": "Um or, or I don't know I guess I still have it.",
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"text": "OK and uh, are you, any, uh, anything else other than asthma?",
"speaker": "Doctor"
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"text": "Uh, my dad had hypertension.",
"speaker": "Patient"
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"text": "OK.",
"speaker": "Doctor"
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"text": "Has hypertension. Had hypertension. Yeah he died of bowel cancer ten years ago.",
"speaker": "Patient"
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"text": "Yeah .",
"speaker": "Doctor"
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"text": "Ohh dear, OK. Bowel cancer. Ten years ago. And how old was he when he died?",
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"text": "Uh, sixty-two.",
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"text": "K, and um, you mentioned you had asthma, are you using any inhalers at all?",
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"text": "Yes.",
"speaker": "Patient"
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"text": "Which ones?",
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"text": "Lexapro.",
"speaker": "Patient"
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"start": 272.01454,
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"text": "Sorry?",
"speaker": "Doctor"
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"text": "Lexapro.",
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"start": 275.32536,
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"text": " Laxepro.",
"speaker": "Doctor"
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"text": "Yes.",
"speaker": "Patient"
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{
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"text": "OK, not heard of it may. Is it like Salbutamol? Is it like a blue colour?",
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"text": "Yellow.",
"speaker": "Patient"
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"text": "Yellow, OK. I'll have to check that one, not sure. Laxepro.",
"speaker": "Doctor"
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{
"start": 293.76461,
"end": 308.51469,
"text": "OK. Um, that's fine. Any other medication that you're using? Over the counter, anything at all? OK. Right. Any allergies?",
"speaker": "Doctor"
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"start": 302.31384,
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"text": "No.",
"speaker": "Patient"
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"text": "Nothing, yeah, nothing.",
"speaker": "Patient"
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{
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"text": "No allergies at all, righty . Fine so, obviously, you know you just have diarrhea it's about four to five times a day. Um, you're still drinking plenty and you look like you're not dehydrated which is a good sign, OK? Um, when we start worrying about diarrhea is if you're going more than eight times a day. That means probably you are, you know, whatever you're eating is going straight through, OK? You still need to drink plenty of water because you're losing a lot of fluids.",
"speaker": "Doctor"
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"text": "Mmm.",
"speaker": "Patient"
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{
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"text": "OK, when you go to the toilet. Um, things that one would advise is a soft diet. So avoid dairy, fish, meat, eggs, while you're having the diarrhea. Go, sorry?",
"speaker": "Doctor"
},
{
"start": 357.43072,
"end": 366.37439,
"text": " Soft . What is a soft diet? What does that ? Like, outside of, not those things, what do you mean by soft?",
"speaker": "Patient"
},
{
"start": 366.29875,
"end": 406.13003,
"text": "OK, so that will be like crackers, toast, jam, those kind of things that's easily digested. Like what we are good give babies yeah. When they start eating you give, simple food for babies. You don't give eggs or meat the first time they start feeding. So that's the kind of soft diet we're talking about, yeah? Once you are able to, you know keep most of it in, you can start off with some just boiled vegetables and mash. Once you're OK with that for about forty-eight hours then you can start having meat. So just don't have meat once you feel like you're slightly better, because you might go back to square one again, all right?",
"speaker": "Doctor"
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{
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"speaker": "Patient"
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"start": 405.57549,
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"text": "What do you mean OK with that diet, like once?",
"speaker": "Patient"
},
{
"start": 409.10977,
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"text": " Forty-eight hours you're not having any diarrhea, you're fine then you can go and start having meat, egg, fish and all. So that .",
"speaker": "Doctor"
},
{
"start": 416.07962,
"end": 427.1938,
"text": "OK, if if the diarrhoea is getting better but isn't getting, or do you want it to go away completely at that point, or if it's like trending upwards?",
"speaker": "Patient"
},
{
"start": 426.90214,
"end": 453.91404,
"text": "No, no, no preferably just don't because, what why do we say this? It's because it takes much more time for meat to get digested. So because your gut flora, you know, the, the, the bacteria in your gut is not you know as it should be, it takes a bit more effort for one to digest these food. While it doesn't take that much of an effort to, you know digest mash and vegetables. Does that make sense?",
"speaker": "Doctor"
},
{
"start": 454.25234,
"end": 455.22397,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 455.19106,
"end": 472.57494,
"text": "Yeah? So, um, at the same time you could have some, although you can't milk is not a good idea, yoghurts are a good idea because they are probiotics, it help to build up the normal, um gut, gut bacteria back. OK.",
"speaker": "Doctor"
},
{
"start": 472.21089,
"end": 472.89882,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 473.11949,
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"text": "So those kinda, now, things to look out for, if your diarrhoea doesn't go away in a week's time, or if you're passing blood, we need a stool sample, because that means you you may have , um, some particular bugs that might need treatment with antibiotics.",
"speaker": "Doctor"
},
{
"start": 492.38237,
"end": 493.27598,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 493.20476,
"end": 512.02918,
"text": "OK. If you're again, as I've mentioned previously if you're going about six to eight times a day, that means there's a high chance that, uh, you are, having dehydration and you might need to go into hospital at that point in time. If that happens you get in touch with us again, all right?",
"speaker": "Doctor"
},
{
"start": 514.50055,
"end": 515.29155,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 515.34,
"end": 517.52919,
"text": "Any questions? You look a bit confused.",
"speaker": "Doctor"
},
{
"start": 519.13809,
"end": 520.2492,
"text": "No, that's it.",
"speaker": "Patient"
},
{
"start": 520.34001,
"end": 533.24548,
"text": "Yeah? OK and also you could get something called Dioralyte over the counter. So, it helps to uh, replenish your, the salts that you've been, that's lost through going to the toilet.",
"speaker": "Doctor"
},
{
"start": 534.20755,
"end": 535.00895,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 535.06981,
"end": 551.74557,
"text": "OK? If you're a bit confused you know you can actually, uh, all this is all recorded in your app. So you can go back. I'll put that all in detail so if, you know I know sometimes it's a bit difficult to process everything, you can go back and read, read the notes.",
"speaker": "Doctor"
},
{
"start": 552.81108,
"end": 555.25135,
"text": "Perfect, that's great.",
"speaker": "Patient"
},
{
"start": 552.928,
"end": 557.31316,
"text": "Is that OK? All right then, you take care.",
"speaker": "Doctor"
},
{
"start": 557.93375,
"end": 558.6628,
"text": "Bye.",
"speaker": "Patient"
},
{
"start": 558.52262,
"end": 559.46115,
"text": "Bye now, bye bye.",
"speaker": "Doctor"
}
],
"doctor_utterances": "Hello, hi, I'm Doctor Jacob and welcome to Babylon. Hello. Nice to meet you too. So just before we start, is it all right if you could confirm your name for me please? And your date of birth? OK, and your address for me please. OK and that's correct, and just to confirm that you're in a secure location and we can have a confidential conversation. OK, uh, you've mentioned on our notes that you're suffering from bad diarrhea. I'm sorry to hear about it. So if you tell me a bit more about it, please. OK. Mmm. Mm-hmm. So you haven't had anything from outside? Nothing dodgy anything ? No. Mm-hmm. Repeat that please, that wasn't clear. What did you say? After that we'd said something. OK, right, and with the diarrhea, how many times a day are you going to the toilet? Four to five times, yeah. And is there any? And it's like water? Is it like water or is it just loose? Are you going like water? Or is it just, you know bit, bit of solid stools, bit loose kind of thing? Sure OK. Bit of both and is there any blood or mucus? It's like the snotty stuff. Yeah, it looks like snot . No, so no mucus, OK. Any fever at all? Mm-hmm. Are you still able to eat, and drink? OK. Sure. So but you're you're still able to drink quite a bit yeah? You're drinking plenty. OK. Excellent. OK, and, um, what have you take, have you taken anything so far for the diarrhea? Nothing yet, OK. Anything for the abdominal pain? OK. Right, and any unfortunately we don't have any of your past medical history, is there anything you'd like to say? Mm-hmm. OK and uh, are you, any, uh, anything else other than asthma? OK. Yeah . Ohh dear, OK. Bowel cancer. Ten years ago. And how old was he when he died? K, and um, you mentioned you had asthma, are you using any inhalers at all? Which ones? Sorry? Laxepro. OK, not heard of it may. Is it like Salbutamol? Is it like a blue colour? Yellow, OK. I'll have to check that one, not sure. Laxepro. OK. Um, that's fine. Any other medication that you're using? Over the counter, anything at all? OK. Right. Any allergies? No allergies at all, righty . Fine so, obviously, you know you just have diarrhea it's about four to five times a day. Um, you're still drinking plenty and you look like you're not dehydrated which is a good sign, OK? Um, when we start worrying about diarrhea is if you're going more than eight times a day. That means probably you are, you know, whatever you're eating is going straight through, OK? You still need to drink plenty of water because you're losing a lot of fluids. OK, when you go to the toilet. Um, things that one would advise is a soft diet. So avoid dairy, fish, meat, eggs, while you're having the diarrhea. Go, sorry? OK, so that will be like crackers, toast, jam, those kind of things that's easily digested. Like what we are good give babies yeah. When they start eating you give, simple food for babies. You don't give eggs or meat the first time they start feeding. So that's the kind of soft diet we're talking about, yeah? Once you are able to, you know keep most of it in, you can start off with some just boiled vegetables and mash. Once you're OK with that for about forty-eight hours then you can start having meat. So just don't have meat once you feel like you're slightly better, because you might go back to square one again, all right? Forty-eight hours you're not having any diarrhea, you're fine then you can go and start having meat, egg, fish and all. So that . No, no, no preferably just don't because, what why do we say this? It's because it takes much more time for meat to get digested. So because your gut flora, you know, the, the, the bacteria in your gut is not you know as it should be, it takes a bit more effort for one to digest these food. While it doesn't take that much of an effort to, you know digest mash and vegetables. Does that make sense? Yeah? So, um, at the same time you could have some, although you can't milk is not a good idea, yoghurts are a good idea because they are probiotics, it help to build up the normal, um gut, gut bacteria back. OK. So those kinda, now, things to look out for, if your diarrhoea doesn't go away in a week's time, or if you're passing blood, we need a stool sample, because that means you you may have , um, some particular bugs that might need treatment with antibiotics. OK. If you're again, as I've mentioned previously if you're going about six to eight times a day, that means there's a high chance that, uh, you are, having dehydration and you might need to go into hospital at that point in time. If that happens you get in touch with us again, all right? Any questions? You look a bit confused. Yeah? OK and also you could get something called Dioralyte over the counter. So, it helps to uh, replenish your, the salts that you've been, that's lost through going to the toilet. OK? If you're a bit confused you know you can actually, uh, all this is all recorded in your app. So you can go back. I'll put that all in detail so if, you know I know sometimes it's a bit difficult to process everything, you can go back and read, read the notes. Is that OK? All right then, you take care. Bye now, bye bye.",
"patient_utterances": "Hello. Nice to meet you. Michael John . Oh nine two nine eighty-three. Two three one, Leonard, London street uh, sorry, London. Yes. Uh, it's been happening for about, three days now? Um, yeah it, started off uh, was, I don't know it's just something that I thought would go away pretty quickly. I've had that from time to time after eating certain types of food or going on certain travels, but, uh nothing funky in my diet and no travels recently, um and it just kinda kept up. I'm a bit confused as to what to do . No, no no no, just a little bit, yeah I I don't know I mean it's pretty standard diarrhoea, where it's was like a little bit of abdominal pain. I threw up once, that was a little worrying, uh. I threw up once, yeah. Uh, nothing else was worrisome. Uh, four to five. Uh, what do you mean? It probably depends on the time of day to be honest, . No blood. What do you mean mucus? In the stool? No. Uh, maybe a little bit, but. It hasn't been, that in particular hasn't been too worrying. Uh, a little bit of. Appetite loss I guess worse than normal, but also not something I've, like I, if that was alone I wouldn't have, reached out. Yeah yeah yeah. Mostly it's been dry and red. Nothing yet. Uh, nothing yet. Uh, I. Probably I I had asthma. Um or, or I don't know I guess I still have it. Uh, my dad had hypertension. Has hypertension. Had hypertension. Yeah he died of bowel cancer ten years ago. Uh, sixty-two. Yes. Lexapro. Lexapro. Yes. Yellow. No. Nothing, yeah, nothing. Mmm. Soft . What is a soft diet? What does that ? Like, outside of, not those things, what do you mean by soft? What do you mean OK with that diet, like once? OK, if if the diarrhoea is getting better but isn't getting, or do you want it to go away completely at that point, or if it's like trending upwards? Yes. OK. OK. OK. No, that's it. OK. Perfect, that's great. Bye.",
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"reference_note": "{\"day\": 3, \"consultation\": 10, \"presenting_complaint\": \"I have really bad diarrhea\", \"note\": \"Diarrhoea for 3 days \\nAlso associated abdominal pain \\nNo mucous, no blood \\nVomiting once \\nStill eating and drinking \\nDiarrhea like water 4-5 times a day \\nNo fever \\nLoss od appetite \\nDid not eat out \\nNo foreign travel \\nNo dehydration on examination \\nPMH : asthma \\nFH: Dad died of bowel cancer 10 years, HTN\\nMedication ? Lapriso\\nNo allergies \\nDiagnosis: Gastroenteritis\\nPlan : advised soft diet , drink plenty . Start with crackers, soups and mash . Then can build on with mash and vegetable. Can use yoghurts as probiotics and will help build the gut. If the diarhoea goes on for more than a week or there is blood , we would need a stool sample. \\nIf there is diarrhea more than 8 episodes, you may get dehydrated please book an appointment.\\n\", \"highlights\": [\"Diarrhoea\", \"PMH : asthma\", \"Dad died of bowel cancer 10 years HTN\", \"Gastroenteritis\"]}",
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"dialogue": "[Doctor] \n[Doctor] Hello.\n[Patient] Hello. Can you hear me?\n[Doctor] Yeah, I can. Can you hear me?\n[Patient] \n[Doctor] Hi, my name is Doctor Gohill. I'm one of, Hi, I'm one of the physicians that works at Babylon.\n[Patient] \n[Doctor] Are you in a quiet and private space to talk?\n[Patient] I am, yes.\n[Doctor] Good, and can I confirm your name and date of birth please?\n[Patient] Uh, it's Joe Bloggs. It's the seventh, of June, nineteen seventy four.\n[Doctor] Seventy four, and how old does that make you?\n[Patient] Sorry, fifty four . I'm, suppose I'd be fifty three, well, yeah.\n[Doctor] Perfect.\n[Doctor] Great, and it says here, um, it says you're having chest discomfort. Is that correct?\n[Patient] That, that is correct, yes. I'm experiencing discomfort in my chest.\n[Doctor] \n[Doctor] OK, can you tell me a little bit more about your chest discomfort? When it started, and how you're feeling at the moment?\n[Patient] Sure, um, it's been ongoing for, a couple of hours now. Um, I'd say that it's come on, quite suddenly. I was, digging in the garden. And it, if I had to describe where it is, it's somewhere in the middle of my chest. And it's more, it feels like it's pressure, discomfort, than more, than a pain. Um, if I, had to .\n[Patient] If I, if I had to describe what discomfort feeling, it's, it's like someone's sitting on my chest. .\n[Doctor] OK.\n[Patient] And.\n[Patient] Yeah.\n[Doctor] Great. So, you've talked about your chest. Are you still in, discomfort at the moment?\n[Patient] Uh, yes I do smoke, yeah.\n[Doctor] OK, and when it started, how would you rate it out, out of ten?\n[Patient] Say about, say, seven out of ten.\n[Doctor] OK, .\n[Patient] Ten being, very sort of, unbearable and severe pain. Seven is. Quite manageable, well, it's quite .\n[Doctor] OK, and how about now?\n[Patient] Um, it's still the same.\n[Doctor] OK, and tell me before this happened, what were you doing?\n[Patient] Yeah. Um, I was, relaxing. My wife, and, we're watching Jeremy Kyle.\n[Doctor] OK.\n[Patient] still go out into the garden.\n[Doctor] OK, and how often do you do gardening?\n[Patient] Um, every other week. So, fortnightly.\n[Doctor] OK, and are you normally fit and well? So, are you normally OK to garden as you would?\n[Patient] Uh, yes.\n[Doctor] Great, and apart from this, do you have any other medical problems?\n[Patient] Um, high cholesterol, and, I've had hypertension, hypertension.\n[Doctor] OK, so that's high blood pressure, and high cholesterol. Do you take any medicines for that?\n[Patient] \n[Patient] No, I don't take any medicine.\n[Doctor] OK, and are you allergic to anything?\n[Patient] Uh, .\n[Doctor] OK. So, let me summarise what you've told me already. You were gardening a few hours ago, and you experienced chest discomfort, which was roughly seven out of ten.\n[Patient] \n[Doctor] And it feels more like someone's sitting on your chest, as opposed to pain.\n[Patient] Yeah.\n[Patient] Yes, that's great.\n[Doctor] And apart from this, have you noticed anything else unusual, specifically with your breathing?\n[Patient] Uh, yes I have. Um, I've got shortness of breath. And I feel slightly, light-headed.\n[Doctor] OK, and is that getting worse or better?\n[Patient] Um, it's remained the same. Although, I would say recently I've noticed, in terms of sort of breathing, I've had, some difficulty climbing the stairs. And, if I have to sort of walk uphill, there's that sort of challenge as well.\n[Doctor] And when you get short of breath, when you're walking up the stairs, have you noticed any pain?\n[Patient] Um, no pain as such, but there's often calf pain and, leg swellings.\n[Doctor] OK. So, let me confirm. You have the pressure at the moment, and you have shortness of breath, is that correct?\n[Patient] That is correct, yes.\n[Doctor] . So, given what you've told me about your past medical history. I think it might be worth, you calling an ambulance.\n[Patient] OK.\n[Doctor] get you to the hospital as soon as possible. Because, my concern is, it might be something to do with your heart. So, While to you, I will ring an ambulance. Who, should come to your address.\n[Patient] Ohh, OK.\n[Patient] Ohh right.\n[Doctor] But in the meantime, I think we should stay on the phone. So I can gather some more information, that we can give to the paramedics. Is that OK?\n[Patient] OK.\n[Patient] Um, should I, be concerned about anything?\n[Doctor] It's nothing to worry about at the moment, but, given that you've got high blood pressure and high cholesterol, and you've got some chest pain. I'm always worried about the heart first, before anything else.\n[Patient] , OK, .\n[Doctor] , and we, and we need to look after your heart before anything else.\n[Doctor] So, apart from this light-headedness, and this chest discomfort, have you noticed anything else unusual?\n[Patient] Um, nothing, else unusual. Um, I'm not sure if I spoke to you about nausea? I've noticed nausea, but no vomiting, yet.\n[Doctor] Did you have anything to eat or drink this morning?\n[Patient] Um, no.\n[Doctor] And you feel, still feel nauseous at the moment?\n[Patient] I have, yeah. I am, yeah.\n[Doctor] So, I have a couple of other questions to ask you, and I'm gonna reel them off. So, apologies for not letting you talk very much.\n[Patient] OK.\n[Patient] No, that's fine.\n[Doctor] Have you noticed this pressure, radiating to your head?\n[Patient] Uh, not to my head, no.\n[Doctor] And how about to your left, or right arm?\n[Patient] Uh, yes. There is some pain in my left shoulder and arm.\n[Doctor] And does that pain go anywhere else? To your left arm, or to your back?\n[Patient] Uh, no.\n[Doctor] And, have you noticed any problems swallowing, or drinking water?\n[Patient] Uh, no.\n[Doctor] Good. And have you noticed any problems going to the loo?\n[Patient] Uh, no problems going to the loo.\n[Doctor] And you're normally fit and well, apart from the two things you told me about?\n[Patient] Um. Yes, however, there's some problems just, performing daily activities. Um, like I said, with the difficulties climbing up the stairs and going uphill. Um, I try to limit my daily activity to just moving around the house, nothing too strenuous.\n[Doctor] \n[Doctor] And, do you live at home with your wife at the moment?\n[Patient] Uh, yes.\n[Doctor] OK. I would suggest, if she's there, you let her know that, you'll both be having an adventure to the hospital today. So, she might need to get your things together.\n[Patient] OK. Got it, OK.\n[Doctor] The ambulance should be there very soon. In the meantime, I would suggest that you stay calm, and have some water if you need to.\n[Patient] OK.\n[Doctor] Don't take any of those medications.\n[Patient] Right.\n[Patient] OK.\n[Doctor] And the paramedics should be with you, very shortly.\n[Patient] All right.\n[Doctor] So, when they do come, there are two things they will be worried about.\n[Patient] OK.\n[Doctor] The one is your chest, so, your heart. And the second is your breathing, which is your lungs.\n[Patient] Yes.\n[Patient] OK.\n[Doctor] So, they will give you lots of things to breathe through, and attach things to your arms. Just to check, things like your blood pressure, and your heart rate. So, don't be worried.\n[Patient] OK.\n[Doctor] And, when you get to the hospital, you'll be seen by a consultant, pretty, pretty much immediately.\n[Patient] Yeah, .\n[Doctor] \n[Patient] Reassuring, I'm getting .\n[Doctor] Sure. So, I will let the paramedics do their job. And when, you're at the hospital, the consultant would normally call me within a couple of minutes, to let me know how everything's going.\n[Patient] Ohh, that's great.\n[Doctor] Great. I'll um, book another appointment, to see you soon. Uh, , once you've had your adventure.\n[Patient] OK.\n[Patient] That is perfect. Thank you so much.\n[Doctor] No problems. Do you have any questions for me?\n[Patient] Uh, no questions. I'll just await the ambulance.\n[Doctor] Great, thank you very much.\n[Patient] No problems. I'll speak to you soon.\n[Doctor] Bye bye.\n[Patient] Thank you so much. Bye.\n[Doctor] ",
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"text": " get you to the hospital as soon as possible. Because, my concern is, it might be something to do with your heart. So, While to you, I will ring an ambulance. Who, should come to your address.",
"speaker": "Doctor"
},
{
"start": 285.29957,
"end": 286.75205,
"text": "Ohh, OK.",
"speaker": "Patient"
},
{
"start": 292.11572,
"end": 292.75375,
"text": "Ohh right.",
"speaker": "Patient"
},
{
"start": 292.57614,
"end": 299.98251,
"text": "But in the meantime, I think we should stay on the phone. So I can gather some more information, that we can give to the paramedics. Is that OK?",
"speaker": "Doctor"
},
{
"start": 297.20775,
"end": 297.85628,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 300.81645,
"end": 303.53852,
"text": "Um, should I, be concerned about anything?",
"speaker": "Patient"
},
{
"start": 304.06596,
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"text": "It's nothing to worry about at the moment, but, given that you've got high blood pressure and high cholesterol, and you've got some chest pain. I'm always worried about the heart first, before anything else.",
"speaker": "Doctor"
},
{
"start": 314.0249,
"end": 316.29556,
"text": ", OK, .",
"speaker": "Patient"
},
{
"start": 315.31628,
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"text": ", and we, and we need to look after your heart before anything else.",
"speaker": "Doctor"
},
{
"start": 321.08227,
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"text": "So, apart from this light-headedness, and this chest discomfort, have you noticed anything else unusual?",
"speaker": "Doctor"
},
{
"start": 331.39456,
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"text": "Um, nothing, else unusual. Um, I'm not sure if I spoke to you about nausea? I've noticed nausea, but no vomiting, yet.",
"speaker": "Patient"
},
{
"start": 340.05019,
"end": 342.33146,
"text": "Did you have anything to eat or drink this morning?",
"speaker": "Doctor"
},
{
"start": 342.44252,
"end": 343.35529,
"text": "Um, no.",
"speaker": "Patient"
},
{
"start": 344.68459,
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"text": "And you feel, still feel nauseous at the moment?",
"speaker": "Doctor"
},
{
"start": 347.93306,
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"text": "I have, yeah. I am, yeah.",
"speaker": "Patient"
},
{
"start": 350.34364,
"end": 356.48768,
"text": "So, I have a couple of other questions to ask you, and I'm gonna reel them off. So, apologies for not letting you talk very much.",
"speaker": "Doctor"
},
{
"start": 354.57627,
"end": 355.18976,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 356.84274,
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"text": "No, that's fine.",
"speaker": "Patient"
},
{
"start": 357.50982,
"end": 360.87479,
"text": "Have you noticed this pressure, radiating to your head?",
"speaker": "Doctor"
},
{
"start": 361.71454,
"end": 363.44442,
"text": "Uh, not to my head, no.",
"speaker": "Patient"
},
{
"start": 363.42549,
"end": 365.85046,
"text": "And how about to your left, or right arm?",
"speaker": "Doctor"
},
{
"start": 366.63364,
"end": 371.32361,
"text": "Uh, yes. There is some pain in my left shoulder and arm.",
"speaker": "Patient"
},
{
"start": 372.01747,
"end": 375.64588,
"text": "And does that pain go anywhere else? To your left arm, or to your back?",
"speaker": "Doctor"
},
{
"start": 376.2725,
"end": 377.3214,
"text": "Uh, no.",
"speaker": "Patient"
},
{
"start": 378.23849,
"end": 381.76512,
"text": "And, have you noticed any problems swallowing, or drinking water?",
"speaker": "Doctor"
},
{
"start": 384.87286,
"end": 385.72562,
"text": "Uh, no.",
"speaker": "Patient"
},
{
"start": 386.60296,
"end": 390.50704,
"text": "Good. And have you noticed any problems going to the loo?",
"speaker": "Doctor"
},
{
"start": 391.19171,
"end": 392.851,
"text": "Uh, no problems going to the loo.",
"speaker": "Patient"
},
{
"start": 394.32105,
"end": 398.1171,
"text": "And you're normally fit and well, apart from the two things you told me about?",
"speaker": "Doctor"
},
{
"start": 398.6812,
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"text": "Um. Yes, however, there's some problems just, performing daily activities. Um, like I said, with the difficulties climbing up the stairs and going uphill. Um, I try to limit my daily activity to just moving around the house, nothing too strenuous.",
"speaker": "Patient"
},
{
"start": 414.3068,
"end": 414.83979,
"text": "",
"speaker": "Doctor"
},
{
"start": 417.47849,
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"text": "And, do you live at home with your wife at the moment?",
"speaker": "Doctor"
},
{
"start": 420.02464,
"end": 421.04109,
"text": "Uh, yes.",
"speaker": "Patient"
},
{
"start": 420.59992,
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"text": "OK. I would suggest, if she's there, you let her know that, you'll both be having an adventure to the hospital today. So, she might need to get your things together.",
"speaker": "Doctor"
},
{
"start": 428.32679,
"end": 431.47758,
"text": "OK. Got it, OK.",
"speaker": "Patient"
},
{
"start": 431.70656,
"end": 439.19566,
"text": "The ambulance should be there very soon. In the meantime, I would suggest that you stay calm, and have some water if you need to.",
"speaker": "Doctor"
},
{
"start": 434.73028,
"end": 435.39286,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 439.19566,
"end": 441.70542,
"text": "Don't take any of those medications.",
"speaker": "Doctor"
},
{
"start": 439.5754,
"end": 440.13369,
"text": "Right.",
"speaker": "Patient"
},
{
"start": 442.37589,
"end": 442.95871,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 442.37612,
"end": 445.71115,
"text": "And the paramedics should be with you, very shortly.",
"speaker": "Doctor"
},
{
"start": 446.25817,
"end": 446.93915,
"text": "All right.",
"speaker": "Patient"
},
{
"start": 446.8788,
"end": 450.55525,
"text": "So, when they do come, there are two things they will be worried about.",
"speaker": "Doctor"
},
{
"start": 450.72142,
"end": 451.31651,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 451.07029,
"end": 456.31486,
"text": "The one is your chest, so, your heart. And the second is your breathing, which is your lungs.",
"speaker": "Doctor"
},
{
"start": 453.87026,
"end": 454.37946,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 456.54529,
"end": 457.13424,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 456.96759,
"end": 466.50544,
"text": "So, they will give you lots of things to breathe through, and attach things to your arms. Just to check, things like your blood pressure, and your heart rate. So, don't be worried.",
"speaker": "Doctor"
},
{
"start": 466.75044,
"end": 467.24123,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 467.12824,
"end": 472.6606,
"text": "And, when you get to the hospital, you'll be seen by a consultant, pretty, pretty much immediately.",
"speaker": "Doctor"
},
{
"start": 474.49519,
"end": 475.64398,
"text": "Yeah, .",
"speaker": "Patient"
},
{
"start": 474.82812,
"end": 476.09754,
"text": "",
"speaker": "Doctor"
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{
"start": 476.76739,
"end": 478.9659,
"text": "Reassuring, I'm getting .",
"speaker": "Patient"
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{
"start": 479.91156,
"end": 489.80265,
"text": "Sure. So, I will let the paramedics do their job. And when, you're at the hospital, the consultant would normally call me within a couple of minutes, to let me know how everything's going.",
"speaker": "Doctor"
},
{
"start": 489.94895,
"end": 490.80829,
"text": "Ohh, that's great.",
"speaker": "Patient"
},
{
"start": 491.22176,
"end": 496.21527,
"text": "Great. I'll um, book another appointment, to see you soon. Uh, , once you've had your adventure.",
"speaker": "Doctor"
},
{
"start": 494.2734,
"end": 494.85622,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 497.28167,
"end": 498.88859,
"text": "That is perfect. Thank you so much.",
"speaker": "Patient"
},
{
"start": 498.56839,
"end": 500.5982,
"text": "No problems. Do you have any questions for me?",
"speaker": "Doctor"
},
{
"start": 500.38206,
"end": 503.99512,
"text": "Uh, no questions. I'll just await the ambulance.",
"speaker": "Patient"
},
{
"start": 504.6996,
"end": 506.13667,
"text": "Great, thank you very much.",
"speaker": "Doctor"
},
{
"start": 506.24106,
"end": 507.88151,
"text": "No problems. I'll speak to you soon.",
"speaker": "Patient"
},
{
"start": 507.13667,
"end": 508.44801,
"text": "Bye bye.",
"speaker": "Doctor"
},
{
"start": 508.20205,
"end": 510.43605,
"text": "Thank you so much. Bye.",
"speaker": "Patient"
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{
"start": 511.90279,
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"text": "",
"speaker": "Doctor"
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],
"doctor_utterances": " Hello. Yeah, I can. Can you hear me? Hi, my name is Doctor Gohill. I'm one of, Hi, I'm one of the physicians that works at Babylon. Are you in a quiet and private space to talk? Good, and can I confirm your name and date of birth please? Seventy four, and how old does that make you? Perfect. Great, and it says here, um, it says you're having chest discomfort. Is that correct? OK, can you tell me a little bit more about your chest discomfort? When it started, and how you're feeling at the moment? OK. Great. So, you've talked about your chest. Are you still in, discomfort at the moment? OK, and when it started, how would you rate it out, out of ten? OK, . OK, and how about now? OK, and tell me before this happened, what were you doing? OK. OK, and how often do you do gardening? OK, and are you normally fit and well? So, are you normally OK to garden as you would? Great, and apart from this, do you have any other medical problems? OK, so that's high blood pressure, and high cholesterol. Do you take any medicines for that? OK, and are you allergic to anything? OK. So, let me summarise what you've told me already. You were gardening a few hours ago, and you experienced chest discomfort, which was roughly seven out of ten. And it feels more like someone's sitting on your chest, as opposed to pain. And apart from this, have you noticed anything else unusual, specifically with your breathing? OK, and is that getting worse or better? And when you get short of breath, when you're walking up the stairs, have you noticed any pain? OK. So, let me confirm. You have the pressure at the moment, and you have shortness of breath, is that correct? . So, given what you've told me about your past medical history. I think it might be worth, you calling an ambulance. get you to the hospital as soon as possible. Because, my concern is, it might be something to do with your heart. So, While to you, I will ring an ambulance. Who, should come to your address. But in the meantime, I think we should stay on the phone. So I can gather some more information, that we can give to the paramedics. Is that OK? It's nothing to worry about at the moment, but, given that you've got high blood pressure and high cholesterol, and you've got some chest pain. I'm always worried about the heart first, before anything else. , and we, and we need to look after your heart before anything else. So, apart from this light-headedness, and this chest discomfort, have you noticed anything else unusual? Did you have anything to eat or drink this morning? And you feel, still feel nauseous at the moment? So, I have a couple of other questions to ask you, and I'm gonna reel them off. So, apologies for not letting you talk very much. Have you noticed this pressure, radiating to your head? And how about to your left, or right arm? And does that pain go anywhere else? To your left arm, or to your back? And, have you noticed any problems swallowing, or drinking water? Good. And have you noticed any problems going to the loo? And you're normally fit and well, apart from the two things you told me about? And, do you live at home with your wife at the moment? OK. I would suggest, if she's there, you let her know that, you'll both be having an adventure to the hospital today. So, she might need to get your things together. The ambulance should be there very soon. In the meantime, I would suggest that you stay calm, and have some water if you need to. Don't take any of those medications. And the paramedics should be with you, very shortly. So, when they do come, there are two things they will be worried about. The one is your chest, so, your heart. And the second is your breathing, which is your lungs. So, they will give you lots of things to breathe through, and attach things to your arms. Just to check, things like your blood pressure, and your heart rate. So, don't be worried. And, when you get to the hospital, you'll be seen by a consultant, pretty, pretty much immediately. Sure. So, I will let the paramedics do their job. And when, you're at the hospital, the consultant would normally call me within a couple of minutes, to let me know how everything's going. Great. I'll um, book another appointment, to see you soon. Uh, , once you've had your adventure. No problems. Do you have any questions for me? Great, thank you very much. Bye bye. ",
"patient_utterances": "Hello. Can you hear me? I am, yes. Uh, it's Joe Bloggs. It's the seventh, of June, nineteen seventy four. Sorry, fifty four . I'm, suppose I'd be fifty three, well, yeah. That, that is correct, yes. I'm experiencing discomfort in my chest. Sure, um, it's been ongoing for, a couple of hours now. Um, I'd say that it's come on, quite suddenly. I was, digging in the garden. And it, if I had to describe where it is, it's somewhere in the middle of my chest. And it's more, it feels like it's pressure, discomfort, than more, than a pain. Um, if I, had to . If I, if I had to describe what discomfort feeling, it's, it's like someone's sitting on my chest. . And. Yeah. Uh, yes I do smoke, yeah. Say about, say, seven out of ten. Ten being, very sort of, unbearable and severe pain. Seven is. Quite manageable, well, it's quite . Um, it's still the same. Yeah. Um, I was, relaxing. My wife, and, we're watching Jeremy Kyle. still go out into the garden. Um, every other week. So, fortnightly. Uh, yes. Um, high cholesterol, and, I've had hypertension, hypertension. No, I don't take any medicine. Uh, . Yeah. Yes, that's great. Uh, yes I have. Um, I've got shortness of breath. And I feel slightly, light-headed. Um, it's remained the same. Although, I would say recently I've noticed, in terms of sort of breathing, I've had, some difficulty climbing the stairs. And, if I have to sort of walk uphill, there's that sort of challenge as well. Um, no pain as such, but there's often calf pain and, leg swellings. That is correct, yes. OK. Ohh, OK. Ohh right. OK. Um, should I, be concerned about anything? , OK, . Um, nothing, else unusual. Um, I'm not sure if I spoke to you about nausea? I've noticed nausea, but no vomiting, yet. Um, no. I have, yeah. I am, yeah. OK. No, that's fine. Uh, not to my head, no. Uh, yes. There is some pain in my left shoulder and arm. Uh, no. Uh, no. Uh, no problems going to the loo. Um. Yes, however, there's some problems just, performing daily activities. Um, like I said, with the difficulties climbing up the stairs and going uphill. Um, I try to limit my daily activity to just moving around the house, nothing too strenuous. Uh, yes. OK. Got it, OK. OK. Right. OK. All right. OK. Yes. OK. OK. Yeah, . Reassuring, I'm getting . Ohh, that's great. OK. That is perfect. Thank you so much. Uh, no questions. I'll just await the ambulance. No problems. I'll speak to you soon. Thank you so much. Bye.",
"num_turns": 126,
"reference_note": "{\"day\": 4, \"consultation\": 1, \"presenting_complaint\": \"I'm having chest discomfort\", \"note\": \"PC: acute onset left sided chest discomfort / pressure, feels like someone sitting on his chest 7/10, radiating to the left shoulder and arm.\\n1-2 hours in duration, acute onset, 1st presentation started while gardening.\\nNo radiation to the head. \\n\\u2105 nausea no vomiting since presentation\\nSOBAR\\n\\nHPC. longer term hx of reduced ADLs due to SOBOE, walking up hills / stairs with no chest discomfort. \\n\\nPMHx - high cholesterol and high blood pressure. \\n\\n\\nDHx - allergies aspirin.\\n\\nSHx - lives with wife at home, able to walk up stairs until previously\\n\\nDDx - MI, PE, GORD\\n\\nPlan - called ambulance ?? MI for further investigation and assessment.\\n\", \"highlights\": [\"\"]}",
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"dialogue": "[Doctor] Hi.\n[Patient] Hey.\n[Doctor] Hi. Can you hear me?\n[Patient] Yeah. I can hear you.\n[Doctor] Good. Um, my name is Doctor Gohil. I'm one of the physicians that works here at Babylon.\n[Patient] OK.\n[Doctor] May I confirm your name and date of birth, please?\n[Patient] Uh, uh, my name is Sarah Smith. And, my date of birth is the twentieth of April nineteen eighty.\n[Doctor] \n[Patient] Great.\n[Doctor] Nineteen eighty three. And, are you in a space that's private and quiet, and you can talk?\n[Patient] Yeah.\n[Patient] Yeah.\n[Doctor] Good. So, it says, erm, I've got a note to say, it says you're feeling short of breath. Is that correct?\n[Patient] Yeah, yeah.\n[Doctor] OK. Are you able to tell me a little bit more about that?\n[Patient] Yeah. I was watching TV and, um, just like over the last hour, I've started to feel, like, a bit short of breath.\n[Doctor] That is, while you're sitting watching TV?\n[Patient] Yeah.\n[Doctor] OK. And, have you noticed anything like this before?\n[Patient] Um, no.\n[Doctor] OK. And, apart from the shortness of breath, have you noticed anything else?\n[Patient] Um, so, I , I started with a cough yesterday.\n[Doctor] OK.\n[Patient] Um. Yeah. I, I don't know if it's, um, relevant, but I had a C-section a few weeks ago.\n[Doctor] OK. And, how long ago was that? Just a few weeks?\n[Patient] Yeah, four weeks.\n[Doctor] OK. And, are you with baby at the moment?\n[Patient] Yes, I am.\n[Doctor] And, how is baby doing?\n[Patient] Yeah. .\n[Doctor] OK. Any coughs or colds with, uh, them?\n[Patient] No, no. He's fine.\n[Doctor] OK. So, you've noticed shortness of breath for just an hour, while sitting and watching TV?\n[Patient] Yep. Mm-hmm.\n[Doctor] And, you had your C-section a couple of weeks ago?\n[Patient] Yeah.\n[Doctor] And, yesterday you noticed a cough?\n[Patient] Yeah.\n[Doctor] So, talk to me about the cough. Have you bought anything up?\n[Patient] Uh, no, I haven't, no.\n[Doctor] And, when was the last time you were ill with the flu, or symptoms like this?\n[Patient] Um, you know, I get coughs and colds quite a lot, but probably. Good few months ago.\n[Doctor] OK. And, this shortness of breath you're having, is it getting worse?\n[Patient] Um. No. I mean, I don't know. I feel like I'm getting really stressed out because, like, my heart, it's really going.\n[Doctor] OK. So, you're feeling your heart more than normal?\n[Patient] Yeah.\n[Doctor] And, the shortness of breath, does it cause any pain in your chest?\n[Patient] Um, no.\n[Doctor] How about when you take a very deep breath in?\n[Patient] Um, I mean, yeah. My chest feels sore, but so does my C-section scar. You know, it's, it's all tender.\n[Doctor] OK. And, since your C-section, did you have to take any medications?\n[Patient] Um, no. Just some painkillers.\n[Doctor] All right. And, can you remember what the name of those were?\n[Patient] Uh, they gave me some, uh, Codeine.\n[Doctor] And, have you had to use that regularly?\n[Patient] Uh, yeah. I, I've been taking that fairly, fairly regularly. But, probably haven't taken it for a week.\n[Doctor] OK. And, apart from the C-section and the shortness of breath, have you got any other medical problems I should know about?\n[Patient] Yeah.\n[Patient] Um, no.\n[Doctor] And, you were .\n[Patient] tell you, I'm allergic to Ibuprofen, though.\n[Doctor] OK. And, what happens when you take Ibuprofen?\n[Patient] Um. I don't know. Sorry.\n[Doctor] So, I need you to do something for me. Have you measured the rate of your heart before?\n[Patient] Uh, yes.\n[Doctor] Have you measured it recently, either with an iWatch or something similar?\n[Patient] No, I haven't, no.\n[Doctor] OK. We might need to do that over the phone. So, are you able to put your right hand on your left wrist, just underneath your thumb? And, see if you can feel your heartbeat.\n[Patient] Yep.\n[Patient] Yep.\n[Doctor] So, uh, what I need you to do is, when I count to three, count down from three, just count the number of beats you've noticed. And, I'll tell you when to stop. Is that OK?\n[Patient] Mm-hmm. Yep.\n[Doctor] So, we'll start in three, two, one. Go.\n[Doctor] Great. That should be enough. How many did you count?\n[Patient] Uh, I counted thirty.\n[Doctor] Good.\n[Doctor] So, your heart is running slightly fast at the moment, which is probably because of the shortness of breath and some of the pain that you're under.\n[Patient] Mm-hmm.\n[Patient] OK.\n[Doctor] Given that you've had a C-section, and you're short of breath, which has come on quite recently and quite quickly It might be worth you going into the hospital to get checked out the bit further.\n[Patient] OK.\n[Doctor] So, there's two ways of us doing this. The first is, I can call an ambulance. Or, you can take yourself to the hospital with baby.\n[Patient] Mm-hmm.\n[Doctor] Which one would you prefer?\n[Patient] Uh, it feels a bit dramatic to call an ambulance. Um, I, I will, I will go. I will, I will take myself.\n[Doctor] Sure. And, what I would suggest is, go fairly quickly and take some bits for baby at the same time.\n[Patient] OK.\n[Doctor] And, if you're taking any medications like Codeine, don't, don't take them for the time being.\n[Patient] Mm-hmm, OK.\n[Doctor] Is anyone else with you at home?\n[Patient] Uh, no. My partner's at work.\n[Doctor] OK. So, I think that's the best thing to do, for the time being.\n[Patient] Mm-hmm.\n[Doctor] So, what I'm worried about at the moment is, given that you've had a C-section Some people can suffer with clots. And, those can either be found in the legs or your chest, so in your lungs.\n[Patient] Yeah.\n[Doctor] It's quite a common thing to happen. And, it's not something to worry about. But, needs to be checked out in the hospital first.\n[Patient] OK.\n[Doctor] And, if it, if that does become the case, they can give you something to reduce the clot.\n[Patient] All right, OK. That makes sense.\n[Doctor] Fairly quick process.\n[Patient] OK. Yeah. I mean, my mum's had, uh, clots in her legs before. So, I guess, you know. Yeah, that makes sense. I know, I know what they are.\n[Doctor] Good. Are you, uh, are you particularly worried about anything, or do you want to ask me anything, before we go?\n[Patient] No, no. I'm fine. I'll, uh, I'll just take myself to the hospital.\n[Doctor] Great. Thank you so much.\n[Patient] All right. Thank you. Bye.\n[Doctor] ",
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"text": "Uh, uh, my name is Sarah Smith. And, my date of birth is the twentieth of April nineteen eighty.",
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"text": "Nineteen eighty three. And, are you in a space that's private and quiet, and you can talk?",
"speaker": "Doctor"
},
{
"start": 28.62074,
"end": 29.16808,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 31.57966,
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"text": " Yeah.",
"speaker": "Patient"
},
{
"start": 33.67842,
"end": 39.86464,
"text": "Good. So, it says, erm, I've got a note to say, it says you're feeling short of breath. Is that correct?",
"speaker": "Doctor"
},
{
"start": 39.26032,
"end": 40.8077,
"text": "Yeah, yeah.",
"speaker": "Patient"
},
{
"start": 41.80055,
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"text": "OK. Are you able to tell me a little bit more about that?",
"speaker": "Doctor"
},
{
"start": 44.44477,
"end": 51.15742,
"text": "Yeah. I was watching TV and, um, just like over the last hour, I've started to feel, like, a bit short of breath.",
"speaker": "Patient"
},
{
"start": 53.2468,
"end": 55.34522,
"text": "That is, while you're sitting watching TV?",
"speaker": "Doctor"
},
{
"start": 55.45924,
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"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 57.10862,
"end": 60.14135,
"text": "OK. And, have you noticed anything like this before?",
"speaker": "Doctor"
},
{
"start": 60.79436,
"end": 62.33323,
"text": "Um, no.",
"speaker": "Patient"
},
{
"start": 64.49176,
"end": 68.06999,
"text": "OK. And, apart from the shortness of breath, have you noticed anything else?",
"speaker": "Doctor"
},
{
"start": 68.78848,
"end": 72.10564,
"text": "Um, so, I , I started with a cough yesterday.",
"speaker": "Patient"
},
{
"start": 72.05749,
"end": 72.84655,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 75.74691,
"end": 83.02933,
"text": "Um. Yeah. I, I don't know if it's, um, relevant, but I had a C-section a few weeks ago.",
"speaker": "Patient"
},
{
"start": 83.46919,
"end": 86.2883,
"text": "OK. And, how long ago was that? Just a few weeks?",
"speaker": "Doctor"
},
{
"start": 86.53992,
"end": 87.50339,
"text": "Yeah, four weeks.",
"speaker": "Patient"
},
{
"start": 87.71017,
"end": 89.5818,
"text": "OK. And, are you with baby at the moment?",
"speaker": "Doctor"
},
{
"start": 89.99147,
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"text": "Yes, I am.",
"speaker": "Patient"
},
{
"start": 91.85575,
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"text": "And, how is baby doing?",
"speaker": "Doctor"
},
{
"start": 93.93912,
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"text": "Yeah. .",
"speaker": "Patient"
},
{
"start": 95.06127,
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"text": "OK. Any coughs or colds with, uh, them?",
"speaker": "Doctor"
},
{
"start": 98.80688,
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"text": "No, no. He's fine.",
"speaker": "Patient"
},
{
"start": 100.21146,
"end": 105.27124,
"text": "OK. So, you've noticed shortness of breath for just an hour, while sitting and watching TV?",
"speaker": "Doctor"
},
{
"start": 103.76567,
"end": 105.96906,
"text": "Yep. Mm-hmm.",
"speaker": "Patient"
},
{
"start": 105.75539,
"end": 108.84169,
"text": "And, you had your C-section a couple of weeks ago?",
"speaker": "Doctor"
},
{
"start": 109.17757,
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"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 109.68281,
"end": 111.63991,
"text": "And, yesterday you noticed a cough?",
"speaker": "Doctor"
},
{
"start": 112.10307,
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"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 113.02389,
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"text": "So, talk to me about the cough. Have you bought anything up?",
"speaker": "Doctor"
},
{
"start": 116.50898,
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"text": "Uh, no, I haven't, no.",
"speaker": "Patient"
},
{
"start": 118.51467,
"end": 122.83515,
"text": "And, when was the last time you were ill with the flu, or symptoms like this?",
"speaker": "Doctor"
},
{
"start": 123.31841,
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"text": "Um, you know, I get coughs and colds quite a lot, but probably. Good few months ago.",
"speaker": "Patient"
},
{
"start": 131.95106,
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"text": "OK. And, this shortness of breath you're having, is it getting worse?",
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},
{
"start": 137.06782,
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"text": "Um. No. I mean, I don't know. I feel like I'm getting really stressed out because, like, my heart, it's really going.",
"speaker": "Patient"
},
{
"start": 145.40922,
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"text": "OK. So, you're feeling your heart more than normal?",
"speaker": "Doctor"
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{
"start": 148.21692,
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"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 150.76955,
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"text": "And, the shortness of breath, does it cause any pain in your chest?",
"speaker": "Doctor"
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{
"start": 155.4198,
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"text": "Um, no.",
"speaker": "Patient"
},
{
"start": 157.07263,
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"text": "How about when you take a very deep breath in?",
"speaker": "Doctor"
},
{
"start": 162.02873,
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"text": "Um, I mean, yeah. My chest feels sore, but so does my C-section scar. You know, it's, it's all tender.",
"speaker": "Patient"
},
{
"start": 168.48866,
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"text": "OK. And, since your C-section, did you have to take any medications?",
"speaker": "Doctor"
},
{
"start": 174.19411,
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"text": "Um, no. Just some painkillers.",
"speaker": "Patient"
},
{
"start": 179.3378,
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"text": "All right. And, can you remember what the name of those were?",
"speaker": "Doctor"
},
{
"start": 182.31208,
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"text": "Uh, they gave me some, uh, Codeine.",
"speaker": "Patient"
},
{
"start": 187.60774,
"end": 189.57683,
"text": "And, have you had to use that regularly?",
"speaker": "Doctor"
},
{
"start": 189.90842,
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"text": "Uh, yeah. I, I've been taking that fairly, fairly regularly. But, probably haven't taken it for a week.",
"speaker": "Patient"
},
{
"start": 195.54625,
"end": 201.89859,
"text": "OK. And, apart from the C-section and the shortness of breath, have you got any other medical problems I should know about?",
"speaker": "Doctor"
},
{
"start": 199.47135,
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"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 202.50045,
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"text": "Um, no.",
"speaker": "Patient"
},
{
"start": 205.63935,
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"text": "And, you were .",
"speaker": "Doctor"
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{
"start": 205.96326,
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"text": " tell you, I'm allergic to Ibuprofen, though.",
"speaker": "Patient"
},
{
"start": 208.83255,
"end": 212.29171,
"text": "OK. And, what happens when you take Ibuprofen?",
"speaker": "Doctor"
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{
"start": 212.82778,
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"text": "Um. I don't know. Sorry.",
"speaker": "Patient"
},
{
"start": 216.32939,
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"text": " So, I need you to do something for me. Have you measured the rate of your heart before?",
"speaker": "Doctor"
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{
"start": 223.23152,
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"text": "Uh, yes.",
"speaker": "Patient"
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{
"start": 224.45604,
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"text": "Have you measured it recently, either with an iWatch or something similar?",
"speaker": "Doctor"
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{
"start": 228.73876,
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"text": "No, I haven't, no.",
"speaker": "Patient"
},
{
"start": 229.72342,
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"text": "OK. We might need to do that over the phone. So, are you able to put your right hand on your left wrist, just underneath your thumb? And, see if you can feel your heartbeat.",
"speaker": "Doctor"
},
{
"start": 238.73623,
"end": 239.41392,
"text": "Yep.",
"speaker": "Patient"
},
{
"start": 241.43439,
"end": 242.15341,
"text": "Yep.",
"speaker": "Patient"
},
{
"start": 242.28121,
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"text": "So, uh, what I need you to do is, when I count to three, count down from three, just count the number of beats you've noticed. And, I'll tell you when to stop. Is that OK?",
"speaker": "Doctor"
},
{
"start": 248.71358,
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"text": "Mm-hmm. Yep.",
"speaker": "Patient"
},
{
"start": 250.9527,
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"text": "So, we'll start in three, two, one. Go.",
"speaker": "Doctor"
},
{
"start": 263.82244,
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"text": "Great. That should be enough. How many did you count?",
"speaker": "Doctor"
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{
"start": 266.83355,
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"text": "Uh, I counted thirty.",
"speaker": "Patient"
},
{
"start": 271.00924,
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"text": "Good.",
"speaker": "Doctor"
},
{
"start": 273.60036,
"end": 280.91339,
"text": "So, your heart is running slightly fast at the moment, which is probably because of the shortness of breath and some of the pain that you're under.",
"speaker": "Doctor"
},
{
"start": 276.69496,
"end": 277.50488,
"text": "Mm-hmm.",
"speaker": "Patient"
},
{
"start": 280.92708,
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"text": "OK.",
"speaker": "Patient"
},
{
"start": 282.08285,
"end": 293.65507,
"text": "Given that you've had a C-section, and you're short of breath, which has come on quite recently and quite quickly It might be worth you going into the hospital to get checked out the bit further.",
"speaker": "Doctor"
},
{
"start": 293.71361,
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"text": "OK.",
"speaker": "Patient"
},
{
"start": 294.52503,
"end": 302.6568,
"text": "So, there's two ways of us doing this. The first is, I can call an ambulance. Or, you can take yourself to the hospital with baby.",
"speaker": "Doctor"
},
{
"start": 302.9141,
"end": 303.66617,
"text": "Mm-hmm.",
"speaker": "Patient"
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{
"start": 303.31894,
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"text": "Which one would you prefer?",
"speaker": "Doctor"
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{
"start": 305.08646,
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"text": "Uh, it feels a bit dramatic to call an ambulance. Um, I, I will, I will go. I will, I will take myself.",
"speaker": "Patient"
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{
"start": 311.44634,
"end": 317.63055,
"text": "Sure. And, what I would suggest is, go fairly quickly and take some bits for baby at the same time.",
"speaker": "Doctor"
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{
"start": 317.67417,
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"text": "OK.",
"speaker": "Patient"
},
{
"start": 318.60762,
"end": 323.43063,
"text": "And, if you're taking any medications like Codeine, don't, don't take them for the time being.",
"speaker": "Doctor"
},
{
"start": 323.63691,
"end": 324.88352,
"text": "Mm-hmm, OK.",
"speaker": "Patient"
},
{
"start": 324.78219,
"end": 326.75436,
"text": "Is anyone else with you at home?",
"speaker": "Doctor"
},
{
"start": 326.86232,
"end": 328.58792,
"text": "Uh, no. My partner's at work.",
"speaker": "Patient"
},
{
"start": 328.68535,
"end": 333.592,
"text": "OK. So, I think that's the best thing to do, for the time being.",
"speaker": "Doctor"
},
{
"start": 333.53568,
"end": 334.35387,
"text": "Mm-hmm.",
"speaker": "Patient"
},
{
"start": 334.36927,
"end": 345.09833,
"text": "So, what I'm worried about at the moment is, given that you've had a C-section Some people can suffer with clots. And, those can either be found in the legs or your chest, so in your lungs.",
"speaker": "Doctor"
},
{
"start": 345.32809,
"end": 346.07189,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 345.66576,
"end": 350.82356,
"text": "It's quite a common thing to happen. And, it's not something to worry about. But, needs to be checked out in the hospital first.",
"speaker": "Doctor"
},
{
"start": 351.07991,
"end": 351.84024,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 351.61335,
"end": 356.20395,
"text": "And, if it, if that does become the case, they can give you something to reduce the clot.",
"speaker": "Doctor"
},
{
"start": 356.46713,
"end": 358.68057,
"text": "All right, OK. That makes sense.",
"speaker": "Patient"
},
{
"start": 357.24567,
"end": 358.62979,
"text": "Fairly quick process.",
"speaker": "Doctor"
},
{
"start": 359.82107,
"end": 368.82548,
"text": "OK. Yeah. I mean, my mum's had, uh, clots in her legs before. So, I guess, you know. Yeah, that makes sense. I know, I know what they are.",
"speaker": "Patient"
},
{
"start": 369.06675,
"end": 373.32061,
"text": "Good. Are you, uh, are you particularly worried about anything, or do you want to ask me anything, before we go?",
"speaker": "Doctor"
},
{
"start": 373.36769,
"end": 377.39068,
"text": "No, no. I'm fine. I'll, uh, I'll just take myself to the hospital.",
"speaker": "Patient"
},
{
"start": 377.19133,
"end": 378.63134,
"text": "Great. Thank you so much.",
"speaker": "Doctor"
},
{
"start": 378.54771,
"end": 380.10742,
"text": "All right. Thank you. Bye.",
"speaker": "Patient"
},
{
"start": 379.40544,
"end": 380.01369,
"text": "",
"speaker": "Doctor"
}
],
"doctor_utterances": "Hi. Hi. Can you hear me? Good. Um, my name is Doctor Gohil. I'm one of the physicians that works here at Babylon. May I confirm your name and date of birth, please? Nineteen eighty three. And, are you in a space that's private and quiet, and you can talk? Good. So, it says, erm, I've got a note to say, it says you're feeling short of breath. Is that correct? OK. Are you able to tell me a little bit more about that? That is, while you're sitting watching TV? OK. And, have you noticed anything like this before? OK. And, apart from the shortness of breath, have you noticed anything else? OK. OK. And, how long ago was that? Just a few weeks? OK. And, are you with baby at the moment? And, how is baby doing? OK. Any coughs or colds with, uh, them? OK. So, you've noticed shortness of breath for just an hour, while sitting and watching TV? And, you had your C-section a couple of weeks ago? And, yesterday you noticed a cough? So, talk to me about the cough. Have you bought anything up? And, when was the last time you were ill with the flu, or symptoms like this? OK. And, this shortness of breath you're having, is it getting worse? OK. So, you're feeling your heart more than normal? And, the shortness of breath, does it cause any pain in your chest? How about when you take a very deep breath in? OK. And, since your C-section, did you have to take any medications? All right. And, can you remember what the name of those were? And, have you had to use that regularly? OK. And, apart from the C-section and the shortness of breath, have you got any other medical problems I should know about? And, you were . OK. And, what happens when you take Ibuprofen? So, I need you to do something for me. Have you measured the rate of your heart before? Have you measured it recently, either with an iWatch or something similar? OK. We might need to do that over the phone. So, are you able to put your right hand on your left wrist, just underneath your thumb? And, see if you can feel your heartbeat. So, uh, what I need you to do is, when I count to three, count down from three, just count the number of beats you've noticed. And, I'll tell you when to stop. Is that OK? So, we'll start in three, two, one. Go. Great. That should be enough. How many did you count? Good. So, your heart is running slightly fast at the moment, which is probably because of the shortness of breath and some of the pain that you're under. Given that you've had a C-section, and you're short of breath, which has come on quite recently and quite quickly It might be worth you going into the hospital to get checked out the bit further. So, there's two ways of us doing this. The first is, I can call an ambulance. Or, you can take yourself to the hospital with baby. Which one would you prefer? Sure. And, what I would suggest is, go fairly quickly and take some bits for baby at the same time. And, if you're taking any medications like Codeine, don't, don't take them for the time being. Is anyone else with you at home? OK. So, I think that's the best thing to do, for the time being. So, what I'm worried about at the moment is, given that you've had a C-section Some people can suffer with clots. And, those can either be found in the legs or your chest, so in your lungs. It's quite a common thing to happen. And, it's not something to worry about. But, needs to be checked out in the hospital first. And, if it, if that does become the case, they can give you something to reduce the clot. Fairly quick process. Good. Are you, uh, are you particularly worried about anything, or do you want to ask me anything, before we go? Great. Thank you so much. ",
"patient_utterances": "Hey. Yeah. I can hear you. OK. Uh, uh, my name is Sarah Smith. And, my date of birth is the twentieth of April nineteen eighty. Great. Yeah. Yeah. Yeah, yeah. Yeah. I was watching TV and, um, just like over the last hour, I've started to feel, like, a bit short of breath. Yeah. Um, no. Um, so, I , I started with a cough yesterday. Um. Yeah. I, I don't know if it's, um, relevant, but I had a C-section a few weeks ago. Yeah, four weeks. Yes, I am. Yeah. . No, no. He's fine. Yep. Mm-hmm. Yeah. Yeah. Uh, no, I haven't, no. Um, you know, I get coughs and colds quite a lot, but probably. Good few months ago. Um. No. I mean, I don't know. I feel like I'm getting really stressed out because, like, my heart, it's really going. Yeah. Um, no. Um, I mean, yeah. My chest feels sore, but so does my C-section scar. You know, it's, it's all tender. Um, no. Just some painkillers. Uh, they gave me some, uh, Codeine. Uh, yeah. I, I've been taking that fairly, fairly regularly. But, probably haven't taken it for a week. Yeah. Um, no. tell you, I'm allergic to Ibuprofen, though. Um. I don't know. Sorry. Uh, yes. No, I haven't, no. Yep. Yep. Mm-hmm. Yep. Uh, I counted thirty. Mm-hmm. OK. OK. Mm-hmm. Uh, it feels a bit dramatic to call an ambulance. Um, I, I will, I will go. I will, I will take myself. OK. Mm-hmm, OK. Uh, no. My partner's at work. Mm-hmm. Yeah. OK. All right, OK. That makes sense. OK. Yeah. I mean, my mum's had, uh, clots in her legs before. So, I guess, you know. Yeah, that makes sense. I know, I know what they are. No, no. I'm fine. I'll, uh, I'll just take myself to the hospital. All right. Thank you. Bye.",
"num_turns": 107,
"reference_note": "{\"day\": 4, \"consultation\": 3, \"presenting_complaint\": \"I'm feeling short of breath\", \"note\": \"PC SOBAR, c section 2-3 weeks ago\\n\\nHPC;\\nSOBAR while watching tv, acute onset. Cough 1/7 previously, unproductive.\\nNo fever, no chills, non positional.\\nNo chest pain, no pain on inspiration\\n\\nC section 2-3 weeks ago. No complications, baby well. No symptoms.\\nNo of blood thinners.\\n\\n\\nPMHx nill\\nDhx. allergies to ibuprofen \\n\\n\\nOex HR via telephone roughly 120bpm . tachy, regular\\n\\n\\nFHx,\\nMother hx of clots on legs.\\n\\nDDx: PE\\n\\nPlan : Further examination and investigation in acute setting.\\n\", \"highlights\": [\"\"]}",
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{
"consultation_id": "day4_consultation04",
"dialogue": "[Doctor] Hi.\n[Patient] Hi.\n[Doctor] Hi. How are you?\n[Patient] Uh, , yeah. I'm all right, thanks. Um, though, I'm actually feeling a bit wheezy.\n[Doctor] OK. My name is Doctor .\n[Patient] Like .\n[Doctor] I'm one of that work for Babylon. Can I confirm your name and date of birth, please?\n[Patient] Uh, yeah. My, my name is, um, uh, Tina Smith. And, I'm forty years old.\n[Doctor] OK. And, are you in a space that's quiet and private?\n[Patient] Uh, yeah, yeah, yeah. I'm just, I'm .\n[Doctor] OK. And, you mentioned that you are wheezy.\n[Patient] Mm-hmm.\n[Doctor] Can you tell me a little bit more about that?\n[Patient] Yeah. So, um, it started, like, about two days ago. Um, I don't know if it's because, you know, I was, like, cleaning the house. And, like, um, all this dust came out of the, the carpet. And, you know, I've always thought that maybe I've got, uh, an allergy to, like, dust. Um, I think so. So, if it was triggered by Um, you know, two days later. Still not gonna be better. So. Um, just getting a little bit worried about it now.\n[Doctor] OK. So, you were cleaning the house two days ago. And, that's when it first started?\n[Patient] Uh, yeah. That's right.\n[Doctor] Did the wheezing start suddenly, or was it gradual?\n[Patient] Uh, so, it started after maybe, uh, an hour or so .\n[Doctor] And, has it got worse over the past two days?\n[Patient] Yeah. So, it get's a bit worse, um, at night, I find.\n[Doctor] OK. And, have you taken anything for the wheeze?\n[Patient] Uh, no. No, I haven't actually.\n[Doctor] OK. And so, and the wheeze has been getting worse. And, today you're particularly worried. Is it because you're finding it hard to breathe or finding it hard to talk?\n[Patient] Yeah, yeah. A bit of both actually. So, um, I'm feeling like a little bit, uh, uh, short of breath.\n[Doctor] OK.\n[Patient] Um, and, actually, when I'm, you know, talking, um, to my friends, I start finding that, uh, sometimes, um, I'm unable to , complete my sentences.\n[Doctor] OK.\n[Patient] Um, it can, it can get really bad, yeah.\n[Doctor] And, when you can breathe, and you take a deep breath, do you notice any pain?\n[Patient] Um. Mmm, no, no. No pain.\n[Doctor] OK. And, have you noticed yourself feeling dizzy or the rooms spinning more than normal?\n[Patient] Uh, no. No dizziness. Uh, none of that.\n[Doctor] OK. And, have you been eating and drinking OK, particularly water?\n[Patient] Yeah, yeah. I think I'm having, like, you know, four or five glasses a day. Yeah.\n[Doctor] OK. And, are you normally fit and well? Or do you have any other medical problems?\n[Patient] Um. Well, actually, uh, I used to have, like, a bit of, um, asthma, uh, as a child. Um, and, also in the summer I sometimes get, um, hay fever.\n[Doctor] And, when you get hay fever, do you take any medications for it?\n[Patient] Uh. Not really.\n[Doctor] OK. And, your asthma, did it resolve when you were a child?\n[Patient] Uh, I think mostly, yeah. I mean, sometimes when I, um, run for, like, long periods, it can, it can start up a bit. But, um, I have, uh, I have, like, an asthma inhaler. I use that.\n[Doctor] OK. So, do you still have your inhalers?\n[Patient] Um, I think I might have one from, like, a couple of months ago.\n[Doctor] OK.\n[Patient] Um.\n[Doctor] But, you don't see your doctor regularly for asthma?\n[Patient] Uh, no, I don't.\n[Doctor] OK. And, apart from this, do you know if you're allergic to anything?\n[Patient] Uh, not that I know of.\n[Doctor] OK. And, how far are you away from a doctor's surgery at the moment?\n[Patient] Sorry, could you repeat that?\n[Doctor] How far are you away from a doctor's surgery at the moment?\n[Patient] Uh, they may be minutes' drive away.\n[Doctor] OK, good. So, given that you've had a history of asthma when you were a child, And, you get hay fever sometimes in the summer. Your shortness of breath. Hi. I've lost, um, video signal. Can you still hear me?\n[Patient] Um, yeah. We just turned off.\n[Doctor] So, given you've got a history of asthma and hay fever. This could be one of two things. But, we want to rule out asthma or an allergy first. So, what you'll need is visit one of our clinics, so we can do some more tests.\n[Patient] OK.\n[Doctor] Such as check your .\n[Patient] OK. Well what sort?\n[Doctor] So, the first thing we would do, is use a small device on your finger, to check the amount of oxygen in your blood.\n[Patient] OK.\n[Doctor] And, from that we can tell if it's asthma or something else.\n[Patient] Right, OK.\n[Doctor] Before this happens, if you've got something, like an antihistamine, which you normally take for hay fever at home, I would take one, just in case it is an allergy you've had from the dust.\n[Patient] OK. Uh, yeah. I don't have any antihistamines at home, unfortunately.\n[Doctor] You might be able to get one on your way to the doctor's surgery. If not, they can prescribe you one.\n[Patient] OK, OK. So, I can just get it over the counter then?\n[Doctor] Yes. And it, they're normally about four to six pounds.\n[Patient] Great.\n[Doctor] Is there anything else that you're particularly worried about, you want to ask me?\n[Patient] Um, um, not really. I mean. I have, before, taken steroids for asthma. 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"doctor_utterances": "Hi. Hi. How are you? OK. My name is Doctor . I'm one of that work for Babylon. Can I confirm your name and date of birth, please? OK. And, are you in a space that's quiet and private? OK. And, you mentioned that you are wheezy. Can you tell me a little bit more about that? OK. So, you were cleaning the house two days ago. And, that's when it first started? Did the wheezing start suddenly, or was it gradual? And, has it got worse over the past two days? OK. And, have you taken anything for the wheeze? OK. And so, and the wheeze has been getting worse. And, today you're particularly worried. Is it because you're finding it hard to breathe or finding it hard to talk? OK. OK. And, when you can breathe, and you take a deep breath, do you notice any pain? OK. And, have you noticed yourself feeling dizzy or the rooms spinning more than normal? OK. And, have you been eating and drinking OK, particularly water? OK. And, are you normally fit and well? Or do you have any other medical problems? And, when you get hay fever, do you take any medications for it? OK. And, your asthma, did it resolve when you were a child? OK. So, do you still have your inhalers? OK. But, you don't see your doctor regularly for asthma? OK. And, apart from this, do you know if you're allergic to anything? OK. And, how far are you away from a doctor's surgery at the moment? How far are you away from a doctor's surgery at the moment? OK, good. So, given that you've had a history of asthma when you were a child, And, you get hay fever sometimes in the summer. Your shortness of breath. Hi. I've lost, um, video signal. Can you still hear me? So, given you've got a history of asthma and hay fever. This could be one of two things. But, we want to rule out asthma or an allergy first. So, what you'll need is visit one of our clinics, so we can do some more tests. Such as check your . So, the first thing we would do, is use a small device on your finger, to check the amount of oxygen in your blood. And, from that we can tell if it's asthma or something else. Before this happens, if you've got something, like an antihistamine, which you normally take for hay fever at home, I would take one, just in case it is an allergy you've had from the dust. You might be able to get one on your way to the doctor's surgery. If not, they can prescribe you one. Yes. And it, they're normally about four to six pounds. Is there anything else that you're particularly worried about, you want to ask me? Yes, that is. And, you may need to take some steroids now. But, we cannot, we, we won't be able to know until we've done those tests first. Cool. So, I'm gonna write a letter for your GP, just to let him know what's happened. And, the consultation with the GP in person shouldn't take too long. Probably ten minutes. Cool. Um, you should get the letter over the app. And then, we can, you can take yourself to the GP. Cool. OK, bye. ",
"patient_utterances": "Hi. Uh, , yeah. I'm all right, thanks. Um, though, I'm actually feeling a bit wheezy. Like . Uh, yeah. My, my name is, um, uh, Tina Smith. And, I'm forty years old. Uh, yeah, yeah, yeah. I'm just, I'm . Mm-hmm. Yeah. So, um, it started, like, about two days ago. Um, I don't know if it's because, you know, I was, like, cleaning the house. And, like, um, all this dust came out of the, the carpet. And, you know, I've always thought that maybe I've got, uh, an allergy to, like, dust. Um, I think so. So, if it was triggered by Um, you know, two days later. Still not gonna be better. So. Um, just getting a little bit worried about it now. Uh, yeah. That's right. Uh, so, it started after maybe, uh, an hour or so . Yeah. So, it get's a bit worse, um, at night, I find. Uh, no. No, I haven't actually. Yeah, yeah. A bit of both actually. So, um, I'm feeling like a little bit, uh, uh, short of breath. Um, and, actually, when I'm, you know, talking, um, to my friends, I start finding that, uh, sometimes, um, I'm unable to , complete my sentences. Um, it can, it can get really bad, yeah. Um. Mmm, no, no. No pain. Uh, no. No dizziness. Uh, none of that. Yeah, yeah. I think I'm having, like, you know, four or five glasses a day. Yeah. Um. Well, actually, uh, I used to have, like, a bit of, um, asthma, uh, as a child. Um, and, also in the summer I sometimes get, um, hay fever. Uh. Not really. Uh, I think mostly, yeah. I mean, sometimes when I, um, run for, like, long periods, it can, it can start up a bit. But, um, I have, uh, I have, like, an asthma inhaler. I use that. Um, I think I might have one from, like, a couple of months ago. Um. Uh, no, I don't. Uh, not that I know of. Sorry, could you repeat that? Uh, they may be minutes' drive away. Um, yeah. We just turned off. OK. OK. Well what sort? OK. Right, OK. OK. Uh, yeah. I don't have any antihistamines at home, unfortunately. OK, OK. So, I can just get it over the counter then? Great. Um, um, not really. I mean. I have, before, taken steroids for asthma. Um, I don't know if that's relevant. OK, OK. All right. How long do you think it will take? OK, that's great. All right. Thank you very much. OK. Thank you. Bye bye.",
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"dialogue": "[Patient] Hello.\n[Doctor] Hello?\n[Patient] Hi, hi.\n[Doctor] Hi, can you hear me?\n[Patient] , I can hear you well.\n[Doctor] Hi, my name is Doctor Gohil. I'm one of the doctors that works at Babylon. Can I, can I check your name and date of birth, please?\n[Patient] Uh, hi doctor. My name is.\n[Patient] Yes my, my name is uh, Roberto Mendoza. And, uh, I'm, I was born on the first of January, of um, uh, nineteen ninety two.\n[Doctor] OK.\n[Doctor] OK, and are you in a space that's quiet and you're able to talk?\n[Patient] Ohh sorry, I um, of nineteen ninety, sorry I'm forty eight. Sorry, I forgot that .\n[Doctor] So, you're forty eight, and are you able to talk at the moment?\n[Patient] Yeah, yeah.\n[Doctor] OK. Tell me, uh, it says here you have a , uh, you're having problems going to the toilet?\n[Patient] Yes, so I have uh, I have um. I don't know how do you say it properly, in English. Uh, I mean without sounding good, like diarrhoea, for, for, yeah. So, it's lasting for like three days. And, uh, yeah, I, I don't know, uh, I don't know, what could cause it. I, uh, um.\n[Doctor] OK.\n[Patient] Uh, I have a bit of uh, pain, abdominal pain. And I, had a bit of vomiting. And uh, uh, yeah. So this uh, kind of like uh, what is happening to me.\n[Doctor] OK. Tell me how you were three days ago, before this started. Did you have any medical problems?\n[Patient] Uh, so I have, I have, I have a, asthma, and I take some uh, some uh, um, inhaler.\n[Doctor] OK.\n[Patient] I don't know, uh, I take an inhaler, um. and um. uh, I have an allergy. I have N, N, NK, NKDA allergy. So, I don't know if it's because, uh, I don't know. Could be the inhaler, or, yeah.\n[Doctor] OK.\n[Doctor] That's . And apart from asthma, do you have anything else?\n[Patient] Uh, I don't maybe it's work, because you know it's, this thing here in the stomach stuff. I, I always have in the back of my head and my father. Because he died about um, ten years ago of bowel cancer.\n[Doctor] Yep.\n[Doctor] OK?\n[Patient] So, yeah, this is kind of uh. Uh, my, my worries. I, I don't know .\n[Doctor] OK. So, you've, you've had the diarrhoea for three days, and now you're having pain and vomiting.\n[Patient] \n[Patient] Yeah.\n[Patient] Yes, yes, .\n[Doctor] Was the diarrhoea been getting better or worse?\n[Patient] Uh, uh, I , I think it, it's not getting better or worse. It's kind of like uh, uh, like, middle, like normal, like uh, it, it, it hasn't gone away, it hasn't worsened.\n[Doctor] OK.\n[Doctor] OK. And how often do you go to the toilet?\n[Patient] I go, I need to go, I, I can't go to work because I need to go like every. I don't is this feeling like I go to the toilet, and then when I finish, I need to, I feel I need to go again.\n[Doctor] OK.\n[Patient] And, and uh, and, yeah. So, I need to be like close to the toilet uh, all the time.\n[Doctor] That must be, that must be hard.\n[Patient] Yeah, yeah, it's.\n[Doctor] Have you had to drink more water than normal?\n[Patient] I don't know, maybe I'm not drinking enough water, yeah. I drink uh, I think I, yeah I don't know. I, I think I don't drink enough water.\n[Doctor] An important question, have you noticed any blood?\n[Patient] Uh, no, I haven't noticed any, any blood.\n[Doctor] And you mentioned tummy pain, can you tell me more about your tummy pain, like where it is, and if it goes anywhere?\n[Patient] So, , the pain is mainly uh, focus in, in the centre area of the abdomen, like under the belly, under the belly button. And, uh, yeah, and sometimes I can hear my stomach, uh, like, it comes, uh, yeah.\n[Doctor] \n[Doctor] Yep.\n[Doctor] OK. You've been able to eat and drink?\n[Patient] Uh, yes, but, yes but I, I go to the toilet also often. So I, I, I, yeah I try not to eat a lot because I, yeah I just, going to the toilet every, ten minute.\n[Doctor] Hmm. And you said the tummy pain's in the middle of your tummy. Does it go anywhere else?\n[Patient] No, no, just there, and it, it seems to be alleviate a bit, toilet, and maybe it's like trapped gas. So, I don't know what it is, but.\n[Doctor] OK. And when was the last time you vomited?\n[Patient] I think it was this morning. This morning, I, but the, the thing is like, because I'm not eating anything now. So, I, I haven't vomited again.\n[Doctor] Did you have any breakfast?\n[Patient] Right, I don't know. I didn't. Uh, no sorry, yes I did actually, I did. Pardon, I had some fruit, I had some fruit.\n[Doctor] OK. And , and you vomited that up, afterwards?\n[Patient] And afterwards, I didn't have anything, then I got a bit of nausea, and I vomited, and then, uh, yeah and that was it, and that was it. And I have any today, and so now I'm, uh, I think I'm OK, but uh, yeah, and I don't, yeah.\n[Doctor] Did you notice any blood when you vomit?\n[Patient] Hmm. I think I do, I think I do, but is uh, uh, no, no actually I can't say sorry, I'm sorry. I, I, I don't think there is blood because uh, yeah it was, it was the strawberries that I was having for breakfast. So, so, yeah, it wasn't blood.\n[Doctor] \n[Doctor] OK. And, um, did you eat anything that you think might of been bad, or anything that could have caused the tummy pain?\n[Patient] Yeah, .\n[Patient] Uh, I, I don't know. To be honest, sometimes I have, when I get a bit of anxiety, I, I use my inhaler. And, but my inhaler kind of um, run out the one. Because you know, I'm a foreigner, so I have uh, this brand, but I bought a new one here.\n[Doctor] Yeah.\n[Doctor] . OK.\n[Patient] And, uh, I don't know maybe this new one has cause it, this, this problem. I don't know.\n[Doctor] OK. OK. It's very unlikely for an inhaler to cause tummy pain, like this. Normally, it's when you eat, um, bad food or food that has gone off, and you normally get symptoms like you have suggested. But just to double-check, have you noticed any problems with your breathing?\n[Patient] Mmm.\n[Patient] Uh-huh.\n[Patient] Um, uh, I, I always have problems with my breathing, because of the asthma like, . When I, , I need to use my inhaler a little bit, but apart of the normal, I haven't, I haven't.\n[Doctor] OK.\n[Doctor] OK. And how about chest, have you noticed any chest pain?\n[Patient] , no, I haven't , I haven't noticed any chest pain.\n[Doctor] OK. And how about, um, walking and talking, are those all both OK?\n[Patient] Uh, walking and talking, uh, yes, yes. Uh, I, I, but uh, but yeah I don't walk very far because uh, I, yeah I need to, I need to go to the toilet now and then. So, I'm spending some time at home.\n[Doctor] Yep. And when you press on your tummy, does it cause any pain?\n[Patient] Ohh, it does a little bit.\n[Doctor] OK.\n[Doctor] Sorry, I was just writing some things down.\n[Patient] Sure.\n[Doctor] So, what it sounds like to me is that you might have eaten something bad, and it's causing your tummy pain. And it's , this is normally called gastroenteritis, so, an infection of the tummy.\n[Patient] OK.\n[Patient] Ohh, OK.\n[Doctor] Normally, when patients have this do some things. Number one is to drink lots of water and fluids, because you're losing lots at the moment. Number two is to make sure and look out for any fevers, so, if you start getting a temperature then you need .\n[Patient] \n[Patient] Mmm, OK.\n[Patient] Uh-huh.\n[Doctor] And please stay home for the time being until you get slightly better.\n[Patient] OK. OK, I, yeah.\n[Doctor] And normally, Normally, things like antibiotics don't help, they make the situation worse.\n[Patient] OK. I didn't, yeah, sorry I didn't. No, I was saying I didn't have any, fever recently. I, I was sweating a little bit the last four days, but I, I. Not sure if, if I had bit of fever, but very, little or, or, I'm, I'm but I don't think so, I don't think. I don't know maybe.\n[Doctor] So, that's. Go ahead.\n[Doctor] So, I think that's what we should do for the time being, if you feel you're getting much worse, than I would suggest you go and see your GP in real, in real life, in person, so they can loot at your belly.\n[Patient] \n[Patient] OK. OK, I will, yeah I will book then, book , I will wait a couple of days to see, or one more day, and then I will book, and then, yeah.\n[Doctor] Great! Cool! Do you have any more questions for me?\n[Patient] Uh, , no, that's uh, that's it. I was maybe just concerned about my father's uh, medical history, that would uh, I could be at some kind of risk.\n[Doctor] Yes. So, the, the things that you've told me are most suggestive of an infection of your tummy and less likely to be something your father had, but if your things don't get worse, then that's something that we can look up from the GP.\n[Patient] OK.\n[Patient] OK, OK. Yeah, that sounds good, that sounds good. OK. Thank you very much doctor, for your time. Bye bye.\n[Doctor] Does that sound OK?\n[Doctor] Thank you .\n[Doctor] Bye bye.",
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"text": "So, , the pain is mainly uh, focus in, in the centre area of the abdomen, like under the belly, under the belly button. And, uh, yeah, and sometimes I can hear my stomach, uh, like, it comes, uh, yeah.",
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"text": "Right, I don't know. I didn't. Uh, no sorry, yes I did actually, I did. Pardon, I had some fruit, I had some fruit.",
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"text": " OK. And , and you vomited that up, afterwards?",
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"text": "And afterwards, I didn't have anything, then I got a bit of nausea, and I vomited, and then, uh, yeah and that was it, and that was it. And I have any today, and so now I'm, uh, I think I'm OK, but uh, yeah, and I don't, yeah.",
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"text": "Hmm. I think I do, I think I do, but is uh, uh, no, no actually I can't say sorry, I'm sorry. I, I, I don't think there is blood because uh, yeah it was, it was the strawberries that I was having for breakfast. So, so, yeah, it wasn't blood.",
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"text": "OK. And, um, did you eat anything that you think might of been bad, or anything that could have caused the tummy pain?",
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"text": "Uh, I, I don't know. To be honest, sometimes I have, when I get a bit of anxiety, I, I use my inhaler. And, but my inhaler kind of um, run out the one. Because you know, I'm a foreigner, so I have uh, this brand, but I bought a new one here.",
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"text": "OK. OK. It's very unlikely for an inhaler to cause tummy pain, like this. Normally, it's when you eat, um, bad food or food that has gone off, and you normally get symptoms like you have suggested. But just to double-check, have you noticed any problems with your breathing?",
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"text": "Mmm.",
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"text": "Uh-huh.",
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"text": "Um, uh, I, I always have problems with my breathing, because of the asthma like, . When I, , I need to use my inhaler a little bit, but apart of the normal, I haven't, I haven't.",
"speaker": "Patient"
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"text": "OK.",
"speaker": "Doctor"
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"text": "OK. And how about chest, have you noticed any chest pain?",
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"text": ", no, I haven't , I haven't noticed any chest pain.",
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"text": "OK. And how about, um, walking and talking, are those all both OK?",
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"text": "Uh, walking and talking, uh, yes, yes. Uh, I, I, but uh, but yeah I don't walk very far because uh, I, yeah I need to, I need to go to the toilet now and then. So, I'm spending some time at home.",
"speaker": "Patient"
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"text": "Yep. And when you press on your tummy, does it cause any pain?",
"speaker": "Doctor"
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"text": "Ohh, it does a little bit.",
"speaker": "Patient"
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"text": "OK.",
"speaker": "Doctor"
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"text": "Sorry, I was just writing some things down.",
"speaker": "Doctor"
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"text": "Sure.",
"speaker": "Patient"
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"text": "So, what it sounds like to me is that you might have eaten something bad, and it's causing your tummy pain. And it's , this is normally called gastroenteritis, so, an infection of the tummy.",
"speaker": "Doctor"
},
{
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"text": "OK.",
"speaker": "Patient"
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"text": "Ohh, OK.",
"speaker": "Patient"
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"text": "Normally, when patients have this do some things. Number one is to drink lots of water and fluids, because you're losing lots at the moment. Number two is to make sure and look out for any fevers, so, if you start getting a temperature then you need .",
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"text": "Mmm, OK.",
"speaker": "Patient"
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"text": "Uh-huh.",
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"text": "And please stay home for the time being until you get slightly better.",
"speaker": "Doctor"
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"text": "OK. OK, I, yeah.",
"speaker": "Patient"
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"text": "And normally, Normally, things like antibiotics don't help, they make the situation worse.",
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"text": "OK. I didn't, yeah, sorry I didn't. No, I was saying I didn't have any, fever recently. I, I was sweating a little bit the last four days, but I, I. Not sure if, if I had bit of fever, but very, little or, or, I'm, I'm but I don't think so, I don't think. I don't know maybe.",
"speaker": "Patient"
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"text": "So, that's. Go ahead.",
"speaker": "Doctor"
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"text": "So, I think that's what we should do for the time being, if you feel you're getting much worse, than I would suggest you go and see your GP in real, in real life, in person, so they can loot at your belly.",
"speaker": "Doctor"
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"text": "OK. OK, I will, yeah I will book then, book , I will wait a couple of days to see, or one more day, and then I will book, and then, yeah.",
"speaker": "Patient"
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{
"start": 539.42088,
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"text": "Great! Cool! Do you have any more questions for me?",
"speaker": "Doctor"
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"text": "Uh, , no, that's uh, that's it. I was maybe just concerned about my father's uh, medical history, that would uh, I could be at some kind of risk.",
"speaker": "Patient"
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"text": "Yes. So, the, the things that you've told me are most suggestive of an infection of your tummy and less likely to be something your father had, but if your things don't get worse, then that's something that we can look up from the GP.",
"speaker": "Doctor"
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"text": "OK.",
"speaker": "Patient"
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"text": "OK, OK. Yeah, that sounds good, that sounds good. OK. Thank you very much doctor, for your time. Bye bye.",
"speaker": "Patient"
},
{
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"text": "Does that sound OK?",
"speaker": "Doctor"
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{
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"text": "Thank you .",
"speaker": "Doctor"
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"doctor_utterances": "Hello? Hi, can you hear me? Hi, my name is Doctor Gohil. I'm one of the doctors that works at Babylon. Can I, can I check your name and date of birth, please? OK. OK, and are you in a space that's quiet and you're able to talk? So, you're forty eight, and are you able to talk at the moment? OK. Tell me, uh, it says here you have a , uh, you're having problems going to the toilet? OK. OK. Tell me how you were three days ago, before this started. Did you have any medical problems? OK. OK. That's . And apart from asthma, do you have anything else? Yep. OK? OK. So, you've, you've had the diarrhoea for three days, and now you're having pain and vomiting. Was the diarrhoea been getting better or worse? OK. OK. And how often do you go to the toilet? OK. That must be, that must be hard. Have you had to drink more water than normal? An important question, have you noticed any blood? And you mentioned tummy pain, can you tell me more about your tummy pain, like where it is, and if it goes anywhere? Yep. OK. You've been able to eat and drink? Hmm. And you said the tummy pain's in the middle of your tummy. Does it go anywhere else? OK. And when was the last time you vomited? Did you have any breakfast? OK. And , and you vomited that up, afterwards? Did you notice any blood when you vomit? OK. And, um, did you eat anything that you think might of been bad, or anything that could have caused the tummy pain? Yeah. . OK. OK. OK. It's very unlikely for an inhaler to cause tummy pain, like this. Normally, it's when you eat, um, bad food or food that has gone off, and you normally get symptoms like you have suggested. But just to double-check, have you noticed any problems with your breathing? OK. OK. And how about chest, have you noticed any chest pain? OK. And how about, um, walking and talking, are those all both OK? Yep. And when you press on your tummy, does it cause any pain? OK. Sorry, I was just writing some things down. So, what it sounds like to me is that you might have eaten something bad, and it's causing your tummy pain. And it's , this is normally called gastroenteritis, so, an infection of the tummy. Normally, when patients have this do some things. Number one is to drink lots of water and fluids, because you're losing lots at the moment. Number two is to make sure and look out for any fevers, so, if you start getting a temperature then you need . And please stay home for the time being until you get slightly better. And normally, Normally, things like antibiotics don't help, they make the situation worse. So, that's. Go ahead. So, I think that's what we should do for the time being, if you feel you're getting much worse, than I would suggest you go and see your GP in real, in real life, in person, so they can loot at your belly. Great! Cool! Do you have any more questions for me? Yes. So, the, the things that you've told me are most suggestive of an infection of your tummy and less likely to be something your father had, but if your things don't get worse, then that's something that we can look up from the GP. Does that sound OK? Thank you . Bye bye.",
"patient_utterances": "Hello. Hi, hi. , I can hear you well. Uh, hi doctor. My name is. Yes my, my name is uh, Roberto Mendoza. And, uh, I'm, I was born on the first of January, of um, uh, nineteen ninety two. Ohh sorry, I um, of nineteen ninety, sorry I'm forty eight. Sorry, I forgot that . Yeah, yeah. Yes, so I have uh, I have um. I don't know how do you say it properly, in English. Uh, I mean without sounding good, like diarrhoea, for, for, yeah. So, it's lasting for like three days. And, uh, yeah, I, I don't know, uh, I don't know, what could cause it. I, uh, um. Uh, I have a bit of uh, pain, abdominal pain. And I, had a bit of vomiting. And uh, uh, yeah. So this uh, kind of like uh, what is happening to me. Uh, so I have, I have, I have a, asthma, and I take some uh, some uh, um, inhaler. I don't know, uh, I take an inhaler, um. and um. uh, I have an allergy. I have N, N, NK, NKDA allergy. So, I don't know if it's because, uh, I don't know. Could be the inhaler, or, yeah. Uh, I don't maybe it's work, because you know it's, this thing here in the stomach stuff. I, I always have in the back of my head and my father. Because he died about um, ten years ago of bowel cancer. So, yeah, this is kind of uh. Uh, my, my worries. I, I don't know . Yeah. Yes, yes, . Uh, uh, I , I think it, it's not getting better or worse. It's kind of like uh, uh, like, middle, like normal, like uh, it, it, it hasn't gone away, it hasn't worsened. I go, I need to go, I, I can't go to work because I need to go like every. I don't is this feeling like I go to the toilet, and then when I finish, I need to, I feel I need to go again. And, and uh, and, yeah. So, I need to be like close to the toilet uh, all the time. Yeah, yeah, it's. I don't know, maybe I'm not drinking enough water, yeah. I drink uh, I think I, yeah I don't know. I, I think I don't drink enough water. Uh, no, I haven't noticed any, any blood. So, , the pain is mainly uh, focus in, in the centre area of the abdomen, like under the belly, under the belly button. And, uh, yeah, and sometimes I can hear my stomach, uh, like, it comes, uh, yeah. Uh, yes, but, yes but I, I go to the toilet also often. So I, I, I, yeah I try not to eat a lot because I, yeah I just, going to the toilet every, ten minute. No, no, just there, and it, it seems to be alleviate a bit, toilet, and maybe it's like trapped gas. So, I don't know what it is, but. I think it was this morning. This morning, I, but the, the thing is like, because I'm not eating anything now. So, I, I haven't vomited again. Right, I don't know. I didn't. Uh, no sorry, yes I did actually, I did. Pardon, I had some fruit, I had some fruit. And afterwards, I didn't have anything, then I got a bit of nausea, and I vomited, and then, uh, yeah and that was it, and that was it. And I have any today, and so now I'm, uh, I think I'm OK, but uh, yeah, and I don't, yeah. Hmm. I think I do, I think I do, but is uh, uh, no, no actually I can't say sorry, I'm sorry. I, I, I don't think there is blood because uh, yeah it was, it was the strawberries that I was having for breakfast. So, so, yeah, it wasn't blood. Yeah, . Uh, I, I don't know. To be honest, sometimes I have, when I get a bit of anxiety, I, I use my inhaler. And, but my inhaler kind of um, run out the one. Because you know, I'm a foreigner, so I have uh, this brand, but I bought a new one here. And, uh, I don't know maybe this new one has cause it, this, this problem. I don't know. Mmm. Uh-huh. Um, uh, I, I always have problems with my breathing, because of the asthma like, . When I, , I need to use my inhaler a little bit, but apart of the normal, I haven't, I haven't. , no, I haven't , I haven't noticed any chest pain. Uh, walking and talking, uh, yes, yes. Uh, I, I, but uh, but yeah I don't walk very far because uh, I, yeah I need to, I need to go to the toilet now and then. So, I'm spending some time at home. Ohh, it does a little bit. Sure. OK. Ohh, OK. Mmm, OK. Uh-huh. OK. OK, I, yeah. OK. I didn't, yeah, sorry I didn't. No, I was saying I didn't have any, fever recently. I, I was sweating a little bit the last four days, but I, I. Not sure if, if I had bit of fever, but very, little or, or, I'm, I'm but I don't think so, I don't think. I don't know maybe. OK. OK, I will, yeah I will book then, book , I will wait a couple of days to see, or one more day, and then I will book, and then, yeah. Uh, , no, that's uh, that's it. I was maybe just concerned about my father's uh, medical history, that would uh, I could be at some kind of risk. OK. OK, OK. Yeah, that sounds good, that sounds good. OK. Thank you very much doctor, for your time. Bye bye.",
"num_turns": 104,
"reference_note": "{\"day\": 4, \"consultation\": 5, \"presenting_complaint\": \"I've had bad diarrhea for 3 days\", \"note\": \"PC; diarrhea and central abdominal pain for 3/7. Now unable to go to work due to frequency of bowel movements. No fevers\\n\\nHPC:\\nDiarrhea +++ 5-6 per day (more) only fluid no blood, feels as if there incomplete evacuation.\\n\\n\\u2105 abdominal pain for since presentation, no radiation, mild to moderate tenderness, and cramping, E+D'ing causing nausea. Feeling of \\u201cgas\\u201d\\n\\nSome vomiting, now unable to tolerate fluids and solids. Ate this morning but vomited immediately. Feels and looks dehydrated.\\n\\nNo problems with breathing, no chest pain, no headache. \\n\\nDHx : NKDA. \\n\\nFHx : father has history of stomach Ca.\\n\\nDDx : gastroenteritis\\n\\nPlan: fluids, paracetamol, advised if symptoms do not improve to visit the gp surgery. \\n\", \"highlights\": [\"\"]}",
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"dialogue": "[Doctor] Ah.\n[Doctor] Hello.\n[Patient] Hello.\n[Doctor] Hi, uh, my name is Doctor Kumar. I'm one of the GPs here. Can I just get you to confirm your name and date of birth for me, please?\n[Patient] Uh, yeah, I'm Maria.\n[Doctor] \n[Patient] Yeah.\n[Doctor] Date of birth?\n[Patient] Sorry?\n[Doctor] And your date of birth?\n[Patient] Um, twenty second uh, of March, of um, ninety.\n[Doctor] \n[Doctor] Again, how can I help today?\n[Patient] Um, so, I'm having like a really, really strong headache. I don't know what is happening. I'm, quite concerned. So, it started in the morning. Um, I feel like um, uh, dizzy. Uh, my vision is a little bit blurred. Um, like, it's, it's really painful, and I'm getting really concerned. Especially because I'm having like these, uh, changes in the vision.\n[Doctor] OK. So, it started this morning, was it a sudden onset headache, did it come on suddenly?\n[Patient] Yeah, yeah, yeah.\n[Doctor] OK. And did it come on really bad or did it start off, uh, like a slight headache and build up to a, a severe headache?\n[Patient] Uh, it came like, kind of suddenly.\n[Doctor] And if , if ten is the worst pain you've ever felt in your life, how bad would you say the pain was between one and ten?\n[Patient] Well, I had the kidney stone, so let's say that that's ten. Um, I have now, , maybe five, well, six, six probably.\n[Doctor] It's not ten. Great!\n[Patient] But, it's more about me being really concerned, because this is very weird.\n[Doctor] OK. No, that's fine. Have you ever had a headache before?\n[Patient] Sorry?\n[Doctor] Have you ever had a headache like this in the past?\n[Patient] Um, well not, really.\n[Doctor] OK. So, it's a first .\n[Patient] Like this, I, yeah, like this, no, definitely. It's something new.\n[Doctor] OK. OK. If you had to say where uh, uh, across the head, uh, the headache is, is it across the front, around the back?\n[Patient] It's in uh, one side, uh, the left side, only.\n[Doctor] And tell me what visual problems are you getting?\n[Patient] My vision is quite blurred. Um, it, it's, it's really weird, like some zigzag lines.\n[Doctor] OK.\n[Patient] Kind of. I don't know how to describe it properly.\n[Doctor] OK. And, um, have you tried any painkillers for this already?\n[Patient] Yeah, I tried Paracetemol, but uh, didn't work. To be honest, I feel exactly the same.\n[Doctor] OK. Um, OK. Um, what time did you take the paracetamol? How long ago was it you'd taken it?\n[Patient] Uh, well, uh, the headache started like four year, four hours ago. So, I would say like, maybe three hours ago, because I couldn't stand it.\n[Doctor] OK. Um, and your visual problem is still ongoing now?\n[Patient] Yeah, yeah, yeah. I feel a little bit, a little bit better. , I cannot stand screens. Um, but, yeah, definitely. And, when I move, like the thing is that if I, if I leave bed, I start to feel like, even worse if I move. So, I just want to have my hay, my head like really, uh, not moving.\n[Doctor] OK. OK, Um, so, what about, , have you felt sort of nauseous or like you want to vomit?\n[Patient] Ohh yeah. Ohh, I forgot to mention, definitely, I vomit twice. Actually, as soon as the, the headache started, I also vomited. So, initially, I thought it was something that I ate, but then the headache started to be really bad, and I still feel nausea.\n[Doctor] Still feel.\n[Patient] To be honest, I'm about to vomit, very soon, I think.\n[Doctor] All right. OK. You've mentioned, in the past, you've had kidney stones, any other medical problems?\n[Patient] Sorry?\n[Doctor] Uh, you've mentioned that in the past, you've had kidney stones. Have you had any other medical problems in the past?\n[Patient] Yes.\n[Patient] Uh, so, uh, uh, not actually. Uh, my mother has migraines. I'm not sure if that's relevant? And uh, also, I have hypothyroidism in the family. So, it might be. I don't know, uh, I've, I don't know.\n[Doctor] , what else do you have in the family?\n[Patient] I think we are losing connection. Sorry, I, I think we lost connection.\n[Doctor] Ohh, can you still hear me? Ohh, it's gone. You can hear me. Um, you said, you mentioned your mother has migraines. What else do you have in the family?\n[Patient] Yeah. Yeah, yeah.\n[Patient] Hypothyroidism.\n[Doctor] Hyperthyroid\n[Patient] . She also has Hypothyroidism.\n[Doctor] OK. Bye. OK. Um, and no other relevant family history?\n[Patient] Uh, no, not that I'm aware.\n[Doctor] And do you take any regular medications?\n[Patient] Uh, no.\n[Doctor] Are you allergic to any medications?\n[Patient] Not that I'm aware, uh. Yeah, not that I'm aware.\n[Doctor] OK. Is there any chance you could be pregnant?\n[Patient] Uh, I really doubt it.\n[Doctor] Fine. And so, you're not allergic to any medications. Fine from. And what, what were you thinking might be going on? I know you seemed quite worried about it. Was there anything in particular you were worried about?\n[Patient] Well, I'm a little bit hypochondriac. So, I feel that this can be some kind of brain tumour, tumour or something? Because, I'm like this is, , really, the pain is so horrible that, or maybe a stroke. I don't know, it's, it's just like you know, you hear so many stories. That, you definitely start wonder, if i should go to A and E urgently, because , I might really have something serious.\n[Doctor] OK. OK, fine. Um, now just, uh, another, uh, question, have you noticed any weakness in your arms or legs, anything like that?\n[Patient] No, no , no, no.\n[Doctor] Uh, and when you're walking, you're able to walk fine in a straight line or is your, your uh walk, are you walking a bit funny?\n[Patient] Uh, not really.\n[Doctor] OK.\n[Patient] It's really about the head. That's why I find it very weird.\n[Doctor] OK. So, just, just to clarify what, what you said . This morning, uh, you woke up and then later on in the, in the morning, about four hours ago, you've developed a headache? Um, on the left side of the head?\n[Patient] Yep.\n[Patient] Yeah.\n[Doctor] Left side of the head, is it behind the eye?\n[Patient] Exactly.\n[Patient] Sorry?\n[Doctor] Is it behind the eye? Is that where the pain is?\n[Patient] Uh, no, no it's, ugh, I don't know how to describe it. But it's, just like, , kind of.\n[Doctor] Um, you've .\n[Doctor] OK. That's fine. You've noticed that your vision is blurry, there's funny lines, you feel a bit nauseous, you vomited twice. Um, and, uh, you feeling dizzy as well, but your, you've got no neurological symptoms. You're walking fine.\n[Patient] Yes.\n[Doctor] Um, and, and you've taken paracetamol and it hasn't helped. Is that all? OK.\n[Patient] No.\n[Doctor] So, it sounds like what you're suffering from is what's known as a migraine. Is that something you've heard of before?\n[Patient] Yeah.\n[Patient] Uh. Uh, no, it's the first time.\n[Doctor] OK.\n[Patient] But, to be honest, I'm very familiar with the disease, because my mother has it, so. Uh, well, but I never had it, and I thought that the onset of migraine will be, you know, in much, uh, early ages. So, that's why I'm not sure, if migraine makes sense. .\n[Doctor] OK. So, um, usually with, with migraines they can present at different times in people's lives, so, sometimes they can present as a child, sometimes they can present when they're older. Um, and sometimes they can present, you know, even postmenopausally. So, there's different, there's different ways you can get migraines. Uh, and the reason why this sounds like migraines is because it's on one side of the head. typical of a migraine, you've got blurry vision, again which is very typical, with the nausea and vomiting, that's also typical of a migraine.\n[Patient] Mm-hmm.\n[Doctor] Now, um, uh, obviously, if the headache is really severe, and I'll suggest some medications you can try, if that doesn't work, we would want to see you, um, as soon as possible, to do like a full neurological exam as well. to make sure that, you know, there's, you know, when we do a more specific examination that, um, everything all seems fine.\n[Patient] Ohh, that's great.\n[Doctor] Um, I I would recommend in the time between now and when we can see you, uh, if you take some medications, maybe something like ibuprofen?\n[Patient] \n[Patient] Yeah.\n[Patient] OK. So, and, uh, you're, you're saying that if this is a migraine, and if I try that medication. This should go away, kind of, today?\n[Doctor] So, yes, a migraine, yeah, no, you know, even sooner than that, we can look at maybe half an hour to forty minutes, depending on what your response to it is, for some people, Uh, whatever medications they take the migraine doesn't improve, um, and they can last from anywhere from four hours to seventy two hours, migraines can last. Um, but .\n[Patient] Ugh. OK. That doesn't sound good.\n[Doctor] No. So, what, there's lots of medication treatments so, there's, it can be ibuprofen with an anti-sickness, um, so and , which you can get from the pharmacy. Um, and you also to drink, uh, sugary and carbonated drinks, something like Coke.\n[Patient] OK.\n[Doctor] For the three of them is, uh, is a good sort of cocktail to start them, then we can go up the treatment ladder, you can get specific migraine relief medication. And that should be something to try between now and when we see you to do the, um, to do the assessment.\n[Patient] OK.\n[Patient] OK. Sounds.\n[Doctor] assessment to where we can see you today at some point.\n[Patient] OK.\n[Doctor] And, but however, if you do take these medications and, you know, by the time your appointment time comes in and you feel much better in yourself, you can cancel it, um, you can give us a call and cancel it.\n[Patient] OK, sounds good, yeah. Sounds, sounds a good plan.\n[Doctor] OK. Uh, any, any questions for me?\n[Patient] Uh, no, thank you very much. You were very helpful.\n[Doctor] All right. OK. Um, any, any further problems between now and your appointment, please do let us know.\n[Patient] OK, yeah. Thank you very much.\n[Doctor] OK. Bye.\n[Patient] Should I disconnect?",
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"text": "Like this, I, yeah, like this, no, definitely. It's something new.",
"speaker": "Patient"
},
{
"start": 128.06398,
"end": 135.2038,
"text": "OK. OK. If you had to say where uh, uh, across the head, uh, the headache is, is it across the front, around the back?",
"speaker": "Doctor"
},
{
"start": 136.53687,
"end": 140.76164,
"text": "It's in uh, one side, uh, the left side, only.",
"speaker": "Patient"
},
{
"start": 140.9127,
"end": 143.77537,
"text": "And tell me what visual problems are you getting?",
"speaker": "Doctor"
},
{
"start": 144.55932,
"end": 151.60267,
"text": "My vision is quite blurred. Um, it, it's, it's really weird, like some zigzag lines.",
"speaker": "Patient"
},
{
"start": 151.55622,
"end": 152.27004,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 152.10385,
"end": 155.24981,
"text": "Kind of. I don't know how to describe it properly.",
"speaker": "Patient"
},
{
"start": 155.29841,
"end": 159.20303,
"text": "OK. And, um, have you tried any painkillers for this already?",
"speaker": "Doctor"
},
{
"start": 159.98328,
"end": 165.44258,
"text": "Yeah, I tried Paracetemol, but uh, didn't work. To be honest, I feel exactly the same.",
"speaker": "Patient"
},
{
"start": 165.61916,
"end": 172.09985,
"text": "OK. Um, OK. Um, what time did you take the paracetamol? How long ago was it you'd taken it?",
"speaker": "Doctor"
},
{
"start": 172.76572,
"end": 181.49112,
"text": "Uh, well, uh, the headache started like four year, four hours ago. So, I would say like, maybe three hours ago, because I couldn't stand it.",
"speaker": "Patient"
},
{
"start": 181.51311,
"end": 185.76353,
"text": "OK. Um, and your visual problem is still ongoing now?",
"speaker": "Doctor"
},
{
"start": 187.39946,
"end": 207.82066,
"text": "Yeah, yeah, yeah. I feel a little bit, a little bit better. , I cannot stand screens. Um, but, yeah, definitely. And, when I move, like the thing is that if I, if I leave bed, I start to feel like, even worse if I move. So, I just want to have my hay, my head like really, uh, not moving.",
"speaker": "Patient"
},
{
"start": 207.82115,
"end": 214.03333,
"text": "OK. OK, Um, so, what about, , have you felt sort of nauseous or like you want to vomit?",
"speaker": "Doctor"
},
{
"start": 214.89689,
"end": 229.9702,
"text": "Ohh yeah. Ohh, I forgot to mention, definitely, I vomit twice. Actually, as soon as the, the headache started, I also vomited. So, initially, I thought it was something that I ate, but then the headache started to be really bad, and I still feel nausea.",
"speaker": "Patient"
},
{
"start": 229.95442,
"end": 230.66043,
"text": "Still feel.",
"speaker": "Doctor"
},
{
"start": 229.9702,
"end": 233.5307,
"text": "To be honest, I'm about to vomit, very soon, I think.",
"speaker": "Patient"
},
{
"start": 233.3981,
"end": 238.9824,
"text": "All right. OK. You've mentioned, in the past, you've had kidney stones, any other medical problems?",
"speaker": "Doctor"
},
{
"start": 240.33528,
"end": 241.17701,
"text": "Sorry?",
"speaker": "Patient"
},
{
"start": 241.17607,
"end": 247.73077,
"text": "Uh, you've mentioned that in the past, you've had kidney stones. Have you had any other medical problems in the past?",
"speaker": "Doctor"
},
{
"start": 245.39296,
"end": 246.08549,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 248.18953,
"end": 264.7861,
"text": "Uh, so, uh, uh, not actually. Uh, my mother has migraines. I'm not sure if that's relevant? And uh, also, I have hypothyroidism in the family. So, it might be. I don't know, uh, I've, I don't know.",
"speaker": "Patient"
},
{
"start": 264.68312,
"end": 266.64282,
"text": ", what else do you have in the family?",
"speaker": "Doctor"
},
{
"start": 269.15948,
"end": 273.56516,
"text": "I think we are losing connection. Sorry, I, I think we lost connection.",
"speaker": "Patient"
},
{
"start": 274.9426,
"end": 282.66136,
"text": "Ohh, can you still hear me? Ohh, it's gone. You can hear me. Um, you said, you mentioned your mother has migraines. What else do you have in the family?",
"speaker": "Doctor"
},
{
"start": 276.79497,
"end": 277.98664,
"text": "Yeah. Yeah, yeah.",
"speaker": "Patient"
},
{
"start": 282.9122,
"end": 284.10398,
"text": "Hypothyroidism.",
"speaker": "Patient"
},
{
"start": 284.21112,
"end": 285.22345,
"text": "Hyperthyroid",
"speaker": "Doctor"
},
{
"start": 284.57639,
"end": 287.17825,
"text": ". She also has Hypothyroidism.",
"speaker": "Patient"
},
{
"start": 287.23209,
"end": 292.52486,
"text": "OK. Bye. OK. Um, and no other relevant family history?",
"speaker": "Doctor"
},
{
"start": 292.98356,
"end": 295.43491,
"text": "Uh, no, not that I'm aware.",
"speaker": "Patient"
},
{
"start": 295.43893,
"end": 298.23376,
"text": "And do you take any regular medications?",
"speaker": "Doctor"
},
{
"start": 299.15346,
"end": 300.9172,
"text": "Uh, no.",
"speaker": "Patient"
},
{
"start": 301.39536,
"end": 303.63015,
"text": "Are you allergic to any medications?",
"speaker": "Doctor"
},
{
"start": 304.27672,
"end": 307.8581,
"text": "Not that I'm aware, uh. Yeah, not that I'm aware.",
"speaker": "Patient"
},
{
"start": 307.95129,
"end": 310.17169,
"text": "OK. Is there any chance you could be pregnant?",
"speaker": "Doctor"
},
{
"start": 311.14546,
"end": 313.12037,
"text": "Uh, I really doubt it.",
"speaker": "Patient"
},
{
"start": 314.98872,
"end": 326.07962,
"text": "Fine. And so, you're not allergic to any medications. Fine from. And what, what were you thinking might be going on? I know you seemed quite worried about it. Was there anything in particular you were worried about?",
"speaker": "Doctor"
},
{
"start": 327.14853,
"end": 349.60398,
"text": "Well, I'm a little bit hypochondriac. So, I feel that this can be some kind of brain tumour, tumour or something? Because, I'm like this is, , really, the pain is so horrible that, or maybe a stroke. I don't know, it's, it's just like you know, you hear so many stories. That, you definitely start wonder, if i should go to A and E urgently, because , I might really have something serious.",
"speaker": "Patient"
},
{
"start": 349.35599,
"end": 358.95675,
"text": "OK. OK, fine. Um, now just, uh, another, uh, question, have you noticed any weakness in your arms or legs, anything like that?",
"speaker": "Doctor"
},
{
"start": 360.12086,
"end": 362.23687,
"text": "No, no , no, no.",
"speaker": "Patient"
},
{
"start": 362.0945,
"end": 369.15867,
"text": "Uh, and when you're walking, you're able to walk fine in a straight line or is your, your uh walk, are you walking a bit funny?",
"speaker": "Doctor"
},
{
"start": 369.32749,
"end": 370.92918,
"text": "Uh, not really.",
"speaker": "Patient"
},
{
"start": 371.1784,
"end": 371.97446,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 372.38599,
"end": 375.63223,
"text": "It's really about the head. That's why I find it very weird.",
"speaker": "Patient"
},
{
"start": 375.41402,
"end": 387.81544,
"text": "OK. So, just, just to clarify what, what you said . This morning, uh, you woke up and then later on in the, in the morning, about four hours ago, you've developed a headache? Um, on the left side of the head?",
"speaker": "Doctor"
},
{
"start": 385.0654,
"end": 385.79202,
"text": "Yep.",
"speaker": "Patient"
},
{
"start": 388.12244,
"end": 388.79162,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 388.56135,
"end": 391.23519,
"text": "Left side of the head, is it behind the eye?",
"speaker": "Doctor"
},
{
"start": 389.46177,
"end": 390.31842,
"text": "Exactly.",
"speaker": "Patient"
},
{
"start": 392.21193,
"end": 393.07524,
"text": "Sorry?",
"speaker": "Patient"
},
{
"start": 392.8495,
"end": 395.7903,
"text": "Is it behind the eye? Is that where the pain is?",
"speaker": "Doctor"
},
{
"start": 396.24707,
"end": 405.45717,
"text": "Uh, no, no it's, ugh, I don't know how to describe it. But it's, just like, , kind of.",
"speaker": "Patient"
},
{
"start": 402.55717,
"end": 405.16285,
"text": "Um, you've .",
"speaker": "Doctor"
},
{
"start": 406.78086,
"end": 421.45778,
"text": "OK. That's fine. You've noticed that your vision is blurry, there's funny lines, you feel a bit nauseous, you vomited twice. Um, and, uh, you feeling dizzy as well, but your, you've got no neurological symptoms. You're walking fine.",
"speaker": "Doctor"
},
{
"start": 415.12265,
"end": 415.98932,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 421.45778,
"end": 426.32984,
"text": "Um, and, and you've taken paracetamol and it hasn't helped. Is that all? OK.",
"speaker": "Doctor"
},
{
"start": 424.69277,
"end": 425.52011,
"text": "No.",
"speaker": "Patient"
},
{
"start": 426.32984,
"end": 432.67525,
"text": "So, it sounds like what you're suffering from is what's known as a migraine. Is that something you've heard of before?",
"speaker": "Doctor"
},
{
"start": 426.62802,
"end": 427.13162,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 432.99873,
"end": 435.96411,
"text": "Uh. Uh, no, it's the first time.",
"speaker": "Patient"
},
{
"start": 435.97665,
"end": 436.91168,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 436.3901,
"end": 452.78437,
"text": "But, to be honest, I'm very familiar with the disease, because my mother has it, so. Uh, well, but I never had it, and I thought that the onset of migraine will be, you know, in much, uh, early ages. So, that's why I'm not sure, if migraine makes sense. .",
"speaker": "Patient"
},
{
"start": 451.82455,
"end": 482.58306,
"text": "OK. So, um, usually with, with migraines they can present at different times in people's lives, so, sometimes they can present as a child, sometimes they can present when they're older. Um, and sometimes they can present, you know, even postmenopausally. So, there's different, there's different ways you can get migraines. Uh, and the reason why this sounds like migraines is because it's on one side of the head. typical of a migraine, you've got blurry vision, again which is very typical, with the nausea and vomiting, that's also typical of a migraine.",
"speaker": "Doctor"
},
{
"start": 474.94837,
"end": 475.76852,
"text": "Mm-hmm.",
"speaker": "Patient"
},
{
"start": 482.58306,
"end": 502.45501,
"text": "Now, um, uh, obviously, if the headache is really severe, and I'll suggest some medications you can try, if that doesn't work, we would want to see you, um, as soon as possible, to do like a full neurological exam as well. to make sure that, you know, there's, you know, when we do a more specific examination that, um, everything all seems fine.",
"speaker": "Doctor"
},
{
"start": 495.22012,
"end": 496.60982,
"text": "Ohh, that's great.",
"speaker": "Patient"
},
{
"start": 502.45501,
"end": 510.71696,
"text": "Um, I I would recommend in the time between now and when we can see you, uh, if you take some medications, maybe something like ibuprofen?",
"speaker": "Doctor"
},
{
"start": 504.32649,
"end": 505.03153,
"text": "",
"speaker": "Patient"
},
{
"start": 507.35071,
"end": 507.91186,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 511.29064,
"end": 520.03316,
"text": "OK. So, and, uh, you're, you're saying that if this is a migraine, and if I try that medication. This should go away, kind of, today?",
"speaker": "Patient"
},
{
"start": 519.96657,
"end": 538.67015,
"text": "So, yes, a migraine, yeah, no, you know, even sooner than that, we can look at maybe half an hour to forty minutes, depending on what your response to it is, for some people, Uh, whatever medications they take the migraine doesn't improve, um, and they can last from anywhere from four hours to seventy two hours, migraines can last. Um, but .",
"speaker": "Doctor"
},
{
"start": 538.10215,
"end": 540.99739,
"text": "Ugh. OK. That doesn't sound good.",
"speaker": "Patient"
},
{
"start": 539.40329,
"end": 555.24132,
"text": " No. So, what, there's lots of medication treatments so, there's, it can be ibuprofen with an anti-sickness, um, so and , which you can get from the pharmacy. Um, and you also to drink, uh, sugary and carbonated drinks, something like Coke.",
"speaker": "Doctor"
},
{
"start": 555.6042,
"end": 556.47785,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 556.19774,
"end": 569.50122,
"text": "For the three of them is, uh, is a good sort of cocktail to start them, then we can go up the treatment ladder, you can get specific migraine relief medication. And that should be something to try between now and when we see you to do the, um, to do the assessment.",
"speaker": "Doctor"
},
{
"start": 564.62865,
"end": 565.17541,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 569.94952,
"end": 571.2897,
"text": "OK. Sounds.",
"speaker": "Patient"
},
{
"start": 570.45393,
"end": 574.18544,
"text": " assessment to where we can see you today at some point.",
"speaker": "Doctor"
},
{
"start": 574.52776,
"end": 575.41984,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 575.47532,
"end": 584.93711,
"text": "And, but however, if you do take these medications and, you know, by the time your appointment time comes in and you feel much better in yourself, you can cancel it, um, you can give us a call and cancel it.",
"speaker": "Doctor"
},
{
"start": 585.18285,
"end": 588.72573,
"text": "OK, sounds good, yeah. Sounds, sounds a good plan.",
"speaker": "Patient"
},
{
"start": 586.68135,
"end": 590.38201,
"text": "OK. Uh, any, any questions for me?",
"speaker": "Doctor"
},
{
"start": 590.50393,
"end": 593.66321,
"text": "Uh, no, thank you very much. You were very helpful.",
"speaker": "Patient"
},
{
"start": 593.48892,
"end": 598.43342,
"text": "All right. OK. Um, any, any further problems between now and your appointment, please do let us know.",
"speaker": "Doctor"
},
{
"start": 599.30032,
"end": 601.50228,
"text": "OK, yeah. Thank you very much.",
"speaker": "Patient"
},
{
"start": 601.31789,
"end": 602.31706,
"text": "OK. Bye.",
"speaker": "Doctor"
},
{
"start": 602.46323,
"end": 604.97344,
"text": " Should I disconnect?",
"speaker": "Patient"
}
],
"doctor_utterances": " Ah. Hello. Hi, uh, my name is Doctor Kumar. I'm one of the GPs here. Can I just get you to confirm your name and date of birth for me, please? Date of birth? And your date of birth? Again, how can I help today? OK. So, it started this morning, was it a sudden onset headache, did it come on suddenly? OK. And did it come on really bad or did it start off, uh, like a slight headache and build up to a, a severe headache? And if , if ten is the worst pain you've ever felt in your life, how bad would you say the pain was between one and ten? It's not ten. Great! OK. No, that's fine. Have you ever had a headache before? Have you ever had a headache like this in the past? OK. So, it's a first . OK. OK. If you had to say where uh, uh, across the head, uh, the headache is, is it across the front, around the back? And tell me what visual problems are you getting? OK. OK. And, um, have you tried any painkillers for this already? OK. Um, OK. Um, what time did you take the paracetamol? How long ago was it you'd taken it? OK. Um, and your visual problem is still ongoing now? OK. OK, Um, so, what about, , have you felt sort of nauseous or like you want to vomit? Still feel. All right. OK. You've mentioned, in the past, you've had kidney stones, any other medical problems? Uh, you've mentioned that in the past, you've had kidney stones. Have you had any other medical problems in the past? , what else do you have in the family? Ohh, can you still hear me? Ohh, it's gone. You can hear me. Um, you said, you mentioned your mother has migraines. What else do you have in the family? Hyperthyroid OK. Bye. OK. Um, and no other relevant family history? And do you take any regular medications? Are you allergic to any medications? OK. Is there any chance you could be pregnant? Fine. And so, you're not allergic to any medications. Fine from. And what, what were you thinking might be going on? I know you seemed quite worried about it. Was there anything in particular you were worried about? OK. OK, fine. Um, now just, uh, another, uh, question, have you noticed any weakness in your arms or legs, anything like that? Uh, and when you're walking, you're able to walk fine in a straight line or is your, your uh walk, are you walking a bit funny? OK. OK. So, just, just to clarify what, what you said . This morning, uh, you woke up and then later on in the, in the morning, about four hours ago, you've developed a headache? Um, on the left side of the head? Left side of the head, is it behind the eye? Is it behind the eye? Is that where the pain is? Um, you've . OK. That's fine. You've noticed that your vision is blurry, there's funny lines, you feel a bit nauseous, you vomited twice. Um, and, uh, you feeling dizzy as well, but your, you've got no neurological symptoms. You're walking fine. Um, and, and you've taken paracetamol and it hasn't helped. Is that all? OK. So, it sounds like what you're suffering from is what's known as a migraine. Is that something you've heard of before? OK. OK. So, um, usually with, with migraines they can present at different times in people's lives, so, sometimes they can present as a child, sometimes they can present when they're older. Um, and sometimes they can present, you know, even postmenopausally. So, there's different, there's different ways you can get migraines. Uh, and the reason why this sounds like migraines is because it's on one side of the head. typical of a migraine, you've got blurry vision, again which is very typical, with the nausea and vomiting, that's also typical of a migraine. Now, um, uh, obviously, if the headache is really severe, and I'll suggest some medications you can try, if that doesn't work, we would want to see you, um, as soon as possible, to do like a full neurological exam as well. to make sure that, you know, there's, you know, when we do a more specific examination that, um, everything all seems fine. Um, I I would recommend in the time between now and when we can see you, uh, if you take some medications, maybe something like ibuprofen? So, yes, a migraine, yeah, no, you know, even sooner than that, we can look at maybe half an hour to forty minutes, depending on what your response to it is, for some people, Uh, whatever medications they take the migraine doesn't improve, um, and they can last from anywhere from four hours to seventy two hours, migraines can last. Um, but . No. So, what, there's lots of medication treatments so, there's, it can be ibuprofen with an anti-sickness, um, so and , which you can get from the pharmacy. Um, and you also to drink, uh, sugary and carbonated drinks, something like Coke. For the three of them is, uh, is a good sort of cocktail to start them, then we can go up the treatment ladder, you can get specific migraine relief medication. And that should be something to try between now and when we see you to do the, um, to do the assessment. assessment to where we can see you today at some point. And, but however, if you do take these medications and, you know, by the time your appointment time comes in and you feel much better in yourself, you can cancel it, um, you can give us a call and cancel it. OK. Uh, any, any questions for me? All right. OK. Um, any, any further problems between now and your appointment, please do let us know. OK. Bye.",
"patient_utterances": "Hello. Uh, yeah, I'm Maria. Yeah. Sorry? Um, twenty second uh, of March, of um, ninety. Um, so, I'm having like a really, really strong headache. I don't know what is happening. I'm, quite concerned. So, it started in the morning. Um, I feel like um, uh, dizzy. Uh, my vision is a little bit blurred. Um, like, it's, it's really painful, and I'm getting really concerned. Especially because I'm having like these, uh, changes in the vision. Yeah, yeah, yeah. Uh, it came like, kind of suddenly. Well, I had the kidney stone, so let's say that that's ten. Um, I have now, , maybe five, well, six, six probably. But, it's more about me being really concerned, because this is very weird. Sorry? Um, well not, really. Like this, I, yeah, like this, no, definitely. It's something new. It's in uh, one side, uh, the left side, only. My vision is quite blurred. Um, it, it's, it's really weird, like some zigzag lines. Kind of. I don't know how to describe it properly. Yeah, I tried Paracetemol, but uh, didn't work. To be honest, I feel exactly the same. Uh, well, uh, the headache started like four year, four hours ago. So, I would say like, maybe three hours ago, because I couldn't stand it. Yeah, yeah, yeah. I feel a little bit, a little bit better. , I cannot stand screens. Um, but, yeah, definitely. And, when I move, like the thing is that if I, if I leave bed, I start to feel like, even worse if I move. So, I just want to have my hay, my head like really, uh, not moving. Ohh yeah. Ohh, I forgot to mention, definitely, I vomit twice. Actually, as soon as the, the headache started, I also vomited. So, initially, I thought it was something that I ate, but then the headache started to be really bad, and I still feel nausea. To be honest, I'm about to vomit, very soon, I think. Sorry? Yes. Uh, so, uh, uh, not actually. Uh, my mother has migraines. I'm not sure if that's relevant? And uh, also, I have hypothyroidism in the family. So, it might be. I don't know, uh, I've, I don't know. I think we are losing connection. Sorry, I, I think we lost connection. Yeah. Yeah, yeah. Hypothyroidism. . She also has Hypothyroidism. Uh, no, not that I'm aware. Uh, no. Not that I'm aware, uh. Yeah, not that I'm aware. Uh, I really doubt it. Well, I'm a little bit hypochondriac. So, I feel that this can be some kind of brain tumour, tumour or something? Because, I'm like this is, , really, the pain is so horrible that, or maybe a stroke. I don't know, it's, it's just like you know, you hear so many stories. That, you definitely start wonder, if i should go to A and E urgently, because , I might really have something serious. No, no , no, no. Uh, not really. It's really about the head. That's why I find it very weird. Yep. Yeah. Exactly. Sorry? Uh, no, no it's, ugh, I don't know how to describe it. But it's, just like, , kind of. Yes. No. Yeah. Uh. Uh, no, it's the first time. But, to be honest, I'm very familiar with the disease, because my mother has it, so. Uh, well, but I never had it, and I thought that the onset of migraine will be, you know, in much, uh, early ages. So, that's why I'm not sure, if migraine makes sense. . Mm-hmm. Ohh, that's great. Yeah. OK. So, and, uh, you're, you're saying that if this is a migraine, and if I try that medication. This should go away, kind of, today? Ugh. OK. That doesn't sound good. OK. OK. OK. Sounds. OK. OK, sounds good, yeah. Sounds, sounds a good plan. Uh, no, thank you very much. You were very helpful. OK, yeah. Thank you very much. Should I disconnect?",
"num_turns": 115,
"reference_note": "{\"day\": 4, \"consultation\": 6, \"presenting_complaint\": \"my chest hurts and it's been hard to breathe\", \"note\": \"Name and DOB confirmed\\nPC: presenting with headache - significant \\nSx. started this morning\\nAssociated symptoms - dizzy / blurry vision - sudden onset headache - severity score - 6/10\\nNew headache\\nHeadache over left side of head \\nVision blurry - funny lines\\nHas tried paracetamol 3 hours ago- no improvement\\nStill having visual problems - some improvement\\nLooking at screens making sx. Worse\\nWhen moving sx. Worse\\nHas felt nauseous - and vomited x2\\nNo neurological symptoms\\n\\nUnlikely to be pregnant\\n\\nWorried re: brain cancer or a stroke - wondering if needs to go to a&e\\n\\nPmh: renal stones\\n\\nDhx: nil regular,\\nNKDA\\n\\nFhx: mother - migraines, Hypothyroidism\\n\\nVideo assessment - appeared well - in a brightly lit environment - does not appear photophobic\\n\\nPlan - 1) ibuprofen + sugary drink + anti sickness to try until appointment\\nLikely migraine however need to consider more serious differentials\\nFor review face to face as 1st onset of headache - to be seen today at earliest - earliest appointment available - will need neurological assessment - also to assess for neck stiffness and fever and rash \\n\", \"highlights\": [\"\"]}",
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"dialogue": "[Doctor] Hello. Can you hear me OK?\n[Patient] Ohh yes, I can. Can you hear me?\n[Doctor] Yeah, good, good. So, my name is Joe. I'm a doctor, um, here at Babylon. Can I just confirm your name, please?\n[Patient] Uh, my name's Vincent.\n[Doctor] And, your date of birth?\n[Patient] Uh. Uh, ninth of May, two thousand and sixteen.\n[Doctor] OK, great.\n[Patient] \n[Doctor] And are you in a, uh, a safe place, ohh sorry, a safe and , confidential place to talk and just, happy to go ahead with the consultation?\n[Patient] Yeah. Yeah, I am.\n[Patient] Yes, yes I am.\n[Doctor] Great. So, how can I help?\n[Patient] Yeah, so, have a . I've been having a cough and a sore throat, for about a week, and, it's been causing me problems. I've had to stay away from work, for about three or four of those days, because of how bad is.\n[Doctor] OK, I'm sorry to hear that. So, you've had a cough, and a sore throat, for about a week? And what came, what, what came first?\n[Patient] Yes.\n[Patient] Uh, the, sore throat came first, and then, after a day or two, the cough.\n[Doctor] OK, OK. And, uh, are you coughing up anything?\n[Patient] No, it's very dry.\n[Doctor] OK, So I'm, I'm just gonna ask a few questions about the, uh, your current symptoms. And a little bit about your background. Um, and, something else about what we can do, a little bit later on in the consultation, to help you. So, before we go on. anything you're particularly concerned about? Um, or have any ideas, what might be going on? You said that you had a cold.\n[Patient] OK.\n[Patient] , well. I mean, you , you know how, we all are. Once this happens, you Google it and, there seems to be, all kinds of bad things it could be. It could be, could be a cold or, flu obviously, but it could also be tuberculosis. It could be, cancer always comes up so. It'll be good if, none of those.\n[Doctor] Great, so, so yeah. I can provide a bit of reassurance, um, and uh, we can talk about those a little bit, as well. And was there anything you were particularly expecting, or hoping to get out of this consultation? Um.\n[Patient] OK.\n[Patient] Uh. Uh, well, uh yeah, so reassurance. So like, hopefully some sense that it's not anything too serious. But also, is there anything you can prescribe me to make it better? Or any advice? Or maybe even a sick note. So that, if I need to stay away from work for a bit longer, I can get one.\n[Doctor] Sure, sure, OK. All right, so, we'll talk a little bit about the symptoms, and I'm sure we can , get a, um, those things, uh, and some reassurance, um, about your concerns.\n[Patient] OK.\n[Doctor] So, um, you mentioned that you started with sore throat about a week ago, developed into bit of a dry cough. Um, , I'll just ask a few questions around those. So, um, do you have any shortness of breath?\n[Patient] No.\n[Patient] Yes, yes, I've been having shortness of, . Yeah, I've been having shortness of breath, yeah.\n[Doctor] You are short of breath. And, uh, do you have any wheeze? Or chest pain?\n[Patient] Uh, yeah, a bit of both .\n[Doctor] You're, you're feeling a bit wheezy, with some chest pain as well.\n[Patient] Yes.\n[Doctor] OK. And, how, ah, when did you start to develop the shortness of breath?\n[Patient] . So, so the sore throat, so today's Friday, sore throat was about, last week, Friday or Thursday. Cough was Saturday or Sunday. So the, so the, shortness of breath was I think, shortly after the cough. So maybe a day or two later. So, three, four days ago.\n[Doctor] Three or four days ago, you started develop . And is the cough worse at night-time?\n[Patient] No, no, it's the same throughout the whole day.\n[Doctor] Same throughout the day. Um, and, uh, when you say you're short of breath. Just need to try and get an idea about how short of breath you are. So, are you able to, so , um, so, uh, like walk up a flight of stairs, for example? Um, or, or, are you short of breath at rest?\n[Patient] Ohh yeah, it's, it's like, so when I'm doing walking. Um, and I do exercises now and then. So it, it hasn't been . Superbad like, hasn't stopped me from doing any of those things, but it's been pretty unusual, and a little bit worrying.\n[Doctor] And you're a bit concerned about that, OK. So, I just need to ask a few, uh, things about your background as well. So, um, do you have any other medical conditions, or medical history?\n[Patient] No, just, no, no , past medical history, no.\n[Doctor] No . No history of asthma?\n[Patient] No.\n[Doctor] Um, and any, uh, uh, history of, uh, clots on your legs, or your lungs? So these . Uh, no one in your family's had those? Clots on the legs, or the lungs?\n[Patient] \n[Patient] Well, my mother had lung cancer.\n[Doctor] Your mother had lung cancer. Do you smoke?\n[Patient] No.\n[Doctor] You ever smoked? Or been exposed to asbestos? That you know of?\n[Patient] Don't know with asbestos. Ever smoked, . I mean, once or twice in Amsterdam, if that counts, but, not really.\n[Doctor] OK. Um, and, uh, this, so just going back to the, your symptoms of shortness of breath, with the cough. It's a dry cough, no, you're not coughing up any flem? Um, do, do you have, uh, and you don't, you say you don't have any chest pain, as such? Um. Uh, are you taking any medications, currently, at the moment?\n[Patient] Uh. No, no.\n[Doctor] OK. Are you allergic to any medications?\n[Patient] Not to any medication, but I'm allergic to peanuts.\n[Doctor] Peanuts. OK. Um, and, uh. You mentioned that your mother had, uh, lung cancer. Um, any other, family history of any significant illnesses, uh, run, running in your family?\n[Patient] No, no, that's the only one. Just lung cancer, from my mother.\n[Doctor] Just lung cancer. OK. And you say you have a cold. So, do you have , sinus congestion? Or, um.\n[Patient] No, it seems to be , entirely with just my throat. So like, my nose is like, .\n[Doctor] So, , just your, just your throat. And, any recent travel? Or have you always lived in the UK?\n[Patient] Uh, no, so I, I, I haven't always lived in the UK. Like, so I was born in the US, and moved over. Well, it was twelve years ago, but, in terms of recent travel. Just to Europe, nowhere too exotic.\n[Doctor] OK, so no, so no recent travel, no significant recent travel any, anywhere. Um, OK. And, are you coughing up anything other than, . Um, uh, so you, you're not coughing up blood, or anything like that? No, no. Um, good. And, uh, are you feeling feverish, hot, cold, sweaty?\n[Patient] Yeah, so, a little bit feverish, uh, um, at first. So the first three or so days of this, but then it, the fever's gone away.\n[Doctor] OK. And in general, do you . Sorry? Yeah.\n[Patient] Yeah, I was just gonna say, also had a bit of a headache. But like, headaches that come and go rather, but like, right now it's fine.\n[Doctor] Uh.\n[Doctor] OK. And in general, would you say you're feeling, you're, you're beginning to, to feel better? Worse? Or, or sort of, um, staying the same?\n[Patient] , so it's like, it's up and down. So, so let's see, so I, , it started last week, and I stayed home from work two days this week. I think it was maybe, Tuesday and then Thursday. So like, I felt better and then worse again, and then better and then worse again. So it's been, yeah, a kind of constant, but constant and being, variable, if that makes .\n[Doctor] OK. And I just , need to ask any, other sort of risk factors. Um. That you may have. So, , um, no sort of significant weight loss? Um, or unexplained weight loss? Any ?\n[Patient] So no weight loss, but I have been, have been losing my appetite recently. And I mean, I usually eat a lot so, and I, and I enjoy eating as well, but like, so that's been a bit concerning.\n[Doctor] You've been losing your appetite recently?\n[Patient] Yes.\n[Doctor] And you're a little bit concerned about that? But you haven't, you haven't lost any weight, that you think of?\n[Patient] Yes.\n[Patient] No. Not that .\n[Doctor] And any, um, sort of rashes or anything? Or, uh, , and you.\n[Patient] No. Not .\n[Doctor] Not that, not that you can think of. OK. Um. So, I would ask to examine you now, but um, I, I don't know if I could sort of look inside your throat, at least. To see if there's a, probably, there's.\n[Patient] Ohh, we can try .\n[Doctor] Ohh no, well, no, it's OK, I , might think about doing a. Have you got any lumps or bumps around your neck? That you can feel?\n[Patient] \n[Patient] Uh. No.\n[Doctor] No that you, no, OK. Um. And, so finally, you, you were talking about, uh, . I mean, it sounds to me that, um, you've been a little bit up and down. Sore throat. Developed a dry cough. Um, you are slightly short of breath, but not too overly concerningly short of breath. What I would say, we're just coming to the end of consultation now, . If you feel significantly worse .\n[Patient] Mm-hmm.\n[Doctor] Um. Uh, if you get more short of breath, or sudden change in your breathlessness. Um, or breathlessness that you are concerned about. Then I would advise you to see, no , go and see a GP. Um, and actually see somebody physically. Um, uh, but I think, for now I can sort of, uh, try and reassure you that, um, if this clears up, as I expect it would. So, I expect this to sort of be getting better in the next, four or five days. Um, if it's not, please get in touch with a medical professional again. Um, and, uh, I would expect it to, and so therefore, I wouldn't be concerned about tuberculosis Um, your concerns about lung cancer, are. And, was that the other thing you're concerned about?\n[Patient] Ohh yeah, yeah. Yeah.\n[Doctor] Yeah. So, so, um, again, if you're not getting better, please see somebody again. Um, I've just got four seconds now. So, nice talking to you. And, have we gotta? We gotta, tidy up, yeah. OK, so, uh.\n[Patient] All right.\n[Doctor] Uh, and I'll provide you with a sick note, just to give you a few more days off work. Um, and paracetemol. Lots of fluids. Um, and, uh, rest up. And, as I say, if you're not feeling better, please get in touch. OK?\n[Patient] Have a good day.\n[Doctor] . Thank you.\n[Patient] Bye.",
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"text": "Yeah, so, have a . I've been having a cough and a sore throat, for about a week, and, it's been causing me problems. I've had to stay away from work, for about three or four of those days, because of how bad is.",
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"text": "OK, I'm sorry to hear that. So, you've had a cough, and a sore throat, for about a week? And what came, what, what came first?",
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"text": "OK, So I'm, I'm just gonna ask a few questions about the, uh, your current symptoms. And a little bit about your background. Um, and, something else about what we can do, a little bit later on in the consultation, to help you. So, before we go on. anything you're particularly concerned about? Um, or have any ideas, what might be going on? You said that you had a cold.",
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"text": ", well. I mean, you , you know how, we all are. Once this happens, you Google it and, there seems to be, all kinds of bad things it could be. It could be, could be a cold or, flu obviously, but it could also be tuberculosis. It could be, cancer always comes up so. It'll be good if, none of those.",
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"text": "Great, so, so yeah. I can provide a bit of reassurance, um, and uh, we can talk about those a little bit, as well. And was there anything you were particularly expecting, or hoping to get out of this consultation? Um.",
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"text": "Uh. Uh, well, uh yeah, so reassurance. So like, hopefully some sense that it's not anything too serious. But also, is there anything you can prescribe me to make it better? Or any advice? Or maybe even a sick note. So that, if I need to stay away from work for a bit longer, I can get one.",
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"text": "So, um, you mentioned that you started with sore throat about a week ago, developed into bit of a dry cough. Um, , I'll just ask a few questions around those. So, um, do you have any shortness of breath?",
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"text": ". So, so the sore throat, so today's Friday, sore throat was about, last week, Friday or Thursday. Cough was Saturday or Sunday. So the, so the, shortness of breath was I think, shortly after the cough. So maybe a day or two later. So, three, four days ago.",
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"text": "OK. Um, and, uh, this, so just going back to the, your symptoms of shortness of breath, with the cough. It's a dry cough, no, you're not coughing up any flem? Um, do, do you have, uh, and you don't, you say you don't have any chest pain, as such? Um. Uh, are you taking any medications, currently, at the moment?",
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"text": "Peanuts. OK. Um, and, uh. You mentioned that your mother had, uh, lung cancer. Um, any other, family history of any significant illnesses, uh, run, running in your family?",
"speaker": "Doctor"
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"text": "No, no, that's the only one. Just lung cancer, from my mother.",
"speaker": "Patient"
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"text": "Just lung cancer. OK. And you say you have a cold. So, do you have , sinus congestion? Or, um.",
"speaker": "Doctor"
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"text": "No, it seems to be , entirely with just my throat. So like, my nose is like, .",
"speaker": "Patient"
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"text": "So, , just your, just your throat. And, any recent travel? Or have you always lived in the UK?",
"speaker": "Doctor"
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"text": "Uh, no, so I, I, I haven't always lived in the UK. Like, so I was born in the US, and moved over. Well, it was twelve years ago, but, in terms of recent travel. Just to Europe, nowhere too exotic.",
"speaker": "Patient"
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"text": "OK, so no, so no recent travel, no significant recent travel any, anywhere. Um, OK. And, are you coughing up anything other than, . Um, uh, so you, you're not coughing up blood, or anything like that? No, no. Um, good. And, uh, are you feeling feverish, hot, cold, sweaty?",
"speaker": "Doctor"
},
{
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"text": "Yeah, so, a little bit feverish, uh, um, at first. So the first three or so days of this, but then it, the fever's gone away.",
"speaker": "Patient"
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"text": "OK. And in general, do you . Sorry? Yeah.",
"speaker": "Doctor"
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"text": " Yeah, I was just gonna say, also had a bit of a headache. But like, headaches that come and go rather, but like, right now it's fine.",
"speaker": "Patient"
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{
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"text": "Uh.",
"speaker": "Doctor"
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"text": "OK. And in general, would you say you're feeling, you're, you're beginning to, to feel better? Worse? Or, or sort of, um, staying the same?",
"speaker": "Doctor"
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"text": ", so it's like, it's up and down. So, so let's see, so I, , it started last week, and I stayed home from work two days this week. I think it was maybe, Tuesday and then Thursday. So like, I felt better and then worse again, and then better and then worse again. So it's been, yeah, a kind of constant, but constant and being, variable, if that makes .",
"speaker": "Patient"
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"text": "OK. And I just , need to ask any, other sort of risk factors. Um. That you may have. So, , um, no sort of significant weight loss? Um, or unexplained weight loss? Any ?",
"speaker": "Doctor"
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{
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"text": "So no weight loss, but I have been, have been losing my appetite recently. And I mean, I usually eat a lot so, and I, and I enjoy eating as well, but like, so that's been a bit concerning.",
"speaker": "Patient"
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"text": "You've been losing your appetite recently?",
"speaker": "Doctor"
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"text": "Yes.",
"speaker": "Patient"
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"text": "And you're a little bit concerned about that? But you haven't, you haven't lost any weight, that you think of?",
"speaker": "Doctor"
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{
"start": 482.59979,
"end": 483.24986,
"text": "Yes.",
"speaker": "Patient"
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{
"start": 485.15476,
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"text": "No. Not that .",
"speaker": "Patient"
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"text": "And any, um, sort of rashes or anything? Or, uh, , and you.",
"speaker": "Doctor"
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{
"start": 492.20384,
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"text": "No. Not .",
"speaker": "Patient"
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"text": "Not that, not that you can think of. OK. Um. So, I would ask to examine you now, but um, I, I don't know if I could sort of look inside your throat, at least. To see if there's a, probably, there's.",
"speaker": "Doctor"
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"start": 507.88279,
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"text": "Ohh, we can try .",
"speaker": "Patient"
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"text": "Ohh no, well, no, it's OK, I , might think about doing a. Have you got any lumps or bumps around your neck? That you can feel?",
"speaker": "Doctor"
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"start": 510.82041,
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"text": "",
"speaker": "Patient"
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"text": "Uh. No.",
"speaker": "Patient"
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"text": "No that you, no, OK. Um. And, so finally, you, you were talking about, uh, . I mean, it sounds to me that, um, you've been a little bit up and down. Sore throat. Developed a dry cough. Um, you are slightly short of breath, but not too overly concerningly short of breath. What I would say, we're just coming to the end of consultation now, . If you feel significantly worse .",
"speaker": "Doctor"
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"start": 533.20397,
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"text": "Mm-hmm.",
"speaker": "Patient"
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"text": "Um. Uh, if you get more short of breath, or sudden change in your breathlessness. Um, or breathlessness that you are concerned about. Then I would advise you to see, no , go and see a GP. Um, and actually see somebody physically. Um, uh, but I think, for now I can sort of, uh, try and reassure you that, um, if this clears up, as I expect it would. So, I expect this to sort of be getting better in the next, four or five days. Um, if it's not, please get in touch with a medical professional again. Um, and, uh, I would expect it to, and so therefore, I wouldn't be concerned about tuberculosis Um, your concerns about lung cancer, are. And, was that the other thing you're concerned about?",
"speaker": "Doctor"
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{
"start": 588.81491,
"end": 590.7015,
"text": "Ohh yeah, yeah. Yeah.",
"speaker": "Patient"
},
{
"start": 590.1378,
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"text": "Yeah. So, so, um, again, if you're not getting better, please see somebody again. Um, I've just got four seconds now. So, nice talking to you. And, have we gotta? We gotta, tidy up, yeah. OK, so, uh.",
"speaker": "Doctor"
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{
"start": 604.08191,
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"text": "All right.",
"speaker": "Patient"
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{
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"text": "Uh, and I'll provide you with a sick note, just to give you a few more days off work. Um, and paracetemol. Lots of fluids. Um, and, uh, rest up. And, as I say, if you're not feeling better, please get in touch. OK?",
"speaker": "Doctor"
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{
"start": 620.28481,
"end": 622.60879,
"text": " Have a good day.",
"speaker": "Patient"
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{
"start": 621.97225,
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"text": ". Thank you.",
"speaker": "Doctor"
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"start": 625.05305,
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"text": "Bye.",
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"doctor_utterances": "Hello. Can you hear me OK? Yeah, good, good. So, my name is Joe. I'm a doctor, um, here at Babylon. Can I just confirm your name, please? And, your date of birth? OK, great. And are you in a, uh, a safe place, ohh sorry, a safe and , confidential place to talk and just, happy to go ahead with the consultation? Great. So, how can I help? OK, I'm sorry to hear that. So, you've had a cough, and a sore throat, for about a week? And what came, what, what came first? OK, OK. And, uh, are you coughing up anything? OK, So I'm, I'm just gonna ask a few questions about the, uh, your current symptoms. And a little bit about your background. Um, and, something else about what we can do, a little bit later on in the consultation, to help you. So, before we go on. anything you're particularly concerned about? Um, or have any ideas, what might be going on? You said that you had a cold. Great, so, so yeah. I can provide a bit of reassurance, um, and uh, we can talk about those a little bit, as well. And was there anything you were particularly expecting, or hoping to get out of this consultation? Um. Sure, sure, OK. All right, so, we'll talk a little bit about the symptoms, and I'm sure we can , get a, um, those things, uh, and some reassurance, um, about your concerns. So, um, you mentioned that you started with sore throat about a week ago, developed into bit of a dry cough. Um, , I'll just ask a few questions around those. So, um, do you have any shortness of breath? You are short of breath. And, uh, do you have any wheeze? Or chest pain? You're, you're feeling a bit wheezy, with some chest pain as well. OK. And, how, ah, when did you start to develop the shortness of breath? Three or four days ago, you started develop . And is the cough worse at night-time? Same throughout the day. Um, and, uh, when you say you're short of breath. Just need to try and get an idea about how short of breath you are. So, are you able to, so , um, so, uh, like walk up a flight of stairs, for example? Um, or, or, are you short of breath at rest? And you're a bit concerned about that, OK. So, I just need to ask a few, uh, things about your background as well. So, um, do you have any other medical conditions, or medical history? No . No history of asthma? Um, and any, uh, uh, history of, uh, clots on your legs, or your lungs? So these . Uh, no one in your family's had those? Clots on the legs, or the lungs? Your mother had lung cancer. Do you smoke? You ever smoked? Or been exposed to asbestos? That you know of? OK. Um, and, uh, this, so just going back to the, your symptoms of shortness of breath, with the cough. It's a dry cough, no, you're not coughing up any flem? Um, do, do you have, uh, and you don't, you say you don't have any chest pain, as such? Um. Uh, are you taking any medications, currently, at the moment? OK. Are you allergic to any medications? Peanuts. OK. Um, and, uh. You mentioned that your mother had, uh, lung cancer. Um, any other, family history of any significant illnesses, uh, run, running in your family? Just lung cancer. OK. And you say you have a cold. So, do you have , sinus congestion? Or, um. So, , just your, just your throat. And, any recent travel? Or have you always lived in the UK? OK, so no, so no recent travel, no significant recent travel any, anywhere. Um, OK. And, are you coughing up anything other than, . Um, uh, so you, you're not coughing up blood, or anything like that? No, no. Um, good. And, uh, are you feeling feverish, hot, cold, sweaty? OK. And in general, do you . Sorry? Yeah. Uh. OK. And in general, would you say you're feeling, you're, you're beginning to, to feel better? Worse? Or, or sort of, um, staying the same? OK. And I just , need to ask any, other sort of risk factors. Um. That you may have. So, , um, no sort of significant weight loss? Um, or unexplained weight loss? Any ? You've been losing your appetite recently? And you're a little bit concerned about that? But you haven't, you haven't lost any weight, that you think of? And any, um, sort of rashes or anything? Or, uh, , and you. Not that, not that you can think of. OK. Um. So, I would ask to examine you now, but um, I, I don't know if I could sort of look inside your throat, at least. To see if there's a, probably, there's. Ohh no, well, no, it's OK, I , might think about doing a. Have you got any lumps or bumps around your neck? That you can feel? No that you, no, OK. Um. And, so finally, you, you were talking about, uh, . I mean, it sounds to me that, um, you've been a little bit up and down. Sore throat. Developed a dry cough. Um, you are slightly short of breath, but not too overly concerningly short of breath. What I would say, we're just coming to the end of consultation now, . If you feel significantly worse . Um. Uh, if you get more short of breath, or sudden change in your breathlessness. Um, or breathlessness that you are concerned about. Then I would advise you to see, no , go and see a GP. Um, and actually see somebody physically. Um, uh, but I think, for now I can sort of, uh, try and reassure you that, um, if this clears up, as I expect it would. So, I expect this to sort of be getting better in the next, four or five days. Um, if it's not, please get in touch with a medical professional again. Um, and, uh, I would expect it to, and so therefore, I wouldn't be concerned about tuberculosis Um, your concerns about lung cancer, are. And, was that the other thing you're concerned about? Yeah. So, so, um, again, if you're not getting better, please see somebody again. Um, I've just got four seconds now. So, nice talking to you. And, have we gotta? We gotta, tidy up, yeah. OK, so, uh. Uh, and I'll provide you with a sick note, just to give you a few more days off work. Um, and paracetemol. Lots of fluids. Um, and, uh, rest up. And, as I say, if you're not feeling better, please get in touch. OK? . Thank you.",
"patient_utterances": "Ohh yes, I can. Can you hear me? Uh, my name's Vincent. Uh. Uh, ninth of May, two thousand and sixteen. Yeah. Yeah, I am. Yes, yes I am. Yeah, so, have a . I've been having a cough and a sore throat, for about a week, and, it's been causing me problems. I've had to stay away from work, for about three or four of those days, because of how bad is. Yes. Uh, the, sore throat came first, and then, after a day or two, the cough. No, it's very dry. OK. , well. I mean, you , you know how, we all are. Once this happens, you Google it and, there seems to be, all kinds of bad things it could be. It could be, could be a cold or, flu obviously, but it could also be tuberculosis. It could be, cancer always comes up so. It'll be good if, none of those. OK. Uh. Uh, well, uh yeah, so reassurance. So like, hopefully some sense that it's not anything too serious. But also, is there anything you can prescribe me to make it better? Or any advice? Or maybe even a sick note. So that, if I need to stay away from work for a bit longer, I can get one. OK. No. Yes, yes, I've been having shortness of, . Yeah, I've been having shortness of breath, yeah. Uh, yeah, a bit of both . Yes. . So, so the sore throat, so today's Friday, sore throat was about, last week, Friday or Thursday. Cough was Saturday or Sunday. So the, so the, shortness of breath was I think, shortly after the cough. So maybe a day or two later. So, three, four days ago. No, no, it's the same throughout the whole day. Ohh yeah, it's, it's like, so when I'm doing walking. Um, and I do exercises now and then. So it, it hasn't been . Superbad like, hasn't stopped me from doing any of those things, but it's been pretty unusual, and a little bit worrying. No, just, no, no , past medical history, no. No. Well, my mother had lung cancer. No. Don't know with asbestos. Ever smoked, . I mean, once or twice in Amsterdam, if that counts, but, not really. Uh. No, no. Not to any medication, but I'm allergic to peanuts. No, no, that's the only one. Just lung cancer, from my mother. No, it seems to be , entirely with just my throat. So like, my nose is like, . Uh, no, so I, I, I haven't always lived in the UK. Like, so I was born in the US, and moved over. Well, it was twelve years ago, but, in terms of recent travel. Just to Europe, nowhere too exotic. Yeah, so, a little bit feverish, uh, um, at first. So the first three or so days of this, but then it, the fever's gone away. Yeah, I was just gonna say, also had a bit of a headache. But like, headaches that come and go rather, but like, right now it's fine. , so it's like, it's up and down. So, so let's see, so I, , it started last week, and I stayed home from work two days this week. I think it was maybe, Tuesday and then Thursday. So like, I felt better and then worse again, and then better and then worse again. So it's been, yeah, a kind of constant, but constant and being, variable, if that makes . So no weight loss, but I have been, have been losing my appetite recently. And I mean, I usually eat a lot so, and I, and I enjoy eating as well, but like, so that's been a bit concerning. Yes. Yes. No. Not that . No. Not . Ohh, we can try . Uh. No. Mm-hmm. Ohh yeah, yeah. Yeah. All right. Have a good day. Bye.",
"num_turns": 91,
"reference_note": "{\"day\": 4, \"consultation\": 7, \"presenting_complaint\": \"I have a cold\", \"note\": \"Name and DOB confirmed. \\nFeeling unwell for 8 days. Started as a sore throat, then developed a cough, Dry. No sputum. Non productive. No blood. No chest pain. \\nMild SOB \\nNot at rest. Not concerning or holding him back. \\nSlight fever symptoms. \\nGradually improving. \\nNo Asthma\\nNo sig PHMx. \\nReduced appatitie. No unintentional weight loss. \\nNo sig travel history. \\nNon smoker.\\n\\nNo Sig drug history\\nFhx - Mother Lung Ca nil else. \\nNKDA\\nShx - No asbestos exposure. \\n\\nLooks well\\n\\nTime off worse cert - But can self certify\\nSafety netted - If worsening symotoms esp SOB (sudden change) needs review. \\nExpect to improve and be better in 5 days. If no better for further medical reveiw at that time. \\n\", \"highlights\": [\"\"]}",
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"dialogue": "[Doctor] \n[Doctor] Hello.\n[Patient] Hi there.\n[Doctor] Hi! Hi there. Uh, my name's Joe. I'm one of the doctors at Babylon. I, just, can I confirm your name please?\n[Patient] , yeah. Uh, my name's .\n[Doctor] Makes sense. Yeah.\n[Doctor] So, . Sorry, your name is?\n[Patient] Name was Brian.\n[Doctor] Brian. Hi Brian. Nice to \n[Patient] Hi.\n[Doctor] Um, uh, and your date of birth.\n[Patient] Yeah, my date of birth is the eighth of August, nineteen eighty two.\n[Doctor] \n[Doctor] Great. And uh, are you in a sort of, uh, confidential place where you can speak freely?\n[Patient] Yeah. No, no one else can hear me.\n[Doctor] Great. And you're happy to continue with the consultation.\n[Patient] Yes.\n[Doctor] Marvelous. OK. So, um, how can i help today?\n[Patient] Yeah, um. So basically it's, just been happening over the last few weeks or so. But I don't really feel like um, like, getting up in the morning's really difficult, and I don't have much energy at all, during the day, um. Often. Yeah just like, doing most things that I would normally find, easy , is become quite difficult.\n[Doctor] OK. So, things have become quite difficult for you.\n[Patient] Yeah.\n[Doctor] Is there anything else?\n[Patient] Um, no it's quite hard to say like. Things like, I'm not, I'm not eating very much at the moment. I just don't feel like I have a lot of energy.\n[Doctor] OK. I'm sorry to hear that. Um, so you had difficulty waking up. No energy, not eating. And that's been going on for a few weeks. When you say a few weeks, do you mean two or three or five? how many hours of sleep? \n[Patient] Actually, well, now I kind of think about it maybe, maybe even longer, um. I guess uh, , might be related to, so I also started a new job, um, slightly recently. Um. It might of even coincided, coincided with uh, with that, job, a couple of months ago.\n[Doctor] When did you start your new job? Two months ago, did you say?\n[Patient] Yeah.\n[Doctor] OK. And, um, so this has been going on perhaps for um, sort of, six weeks or so?\n[Patient] More like, , two months, I would say, yeah.\n[Doctor] OK. Alright. So, um,\n[Doctor] Is there anything that you're particularly, sort of concerned about, um, or hoping to get out of this consultation?\n[Patient] Well, um, I, I know that it's not really normal for me, so, before this phase. So I'd have thing, you know I wouldn't have, uh, any problems sort of. , eating, what I want to eat, or you know, doing standard things in life, and, and, what I want, to do is just like, kind of return to that previous state. Uh, somehow. Um, I'm not sure how that is. Uh, what, what the best ways of doing that are, but, yeah. Do you have some advice or?\n[Doctor] \n[Patient] Whatever, that'd be really useful.\n[Doctor] OK. Sure. OK. Um, well what would I like to do is just ask you a few more, sort of questions around what's been going on, um, and also around your background health and um, and things like that. And then we can go on to sort of what can be done from there. Is that alright?\n[Patient] OK.\n[Doctor] OK, great. so you say you've been, um, feeling unwell with not a lot of energy, difficult waking up in the mornings. Do you tend to just on that , do you tend to wake up early, and then stay in bed in the morning?\n[Patient] Um, actually I'm, just uh, not, not really waking up early. It's more like I'm just having trouble sleeping at all, really. I think that's probably closer.\n[Doctor] , difficulty sleeping as well.\n[Patient] Yeah.\n[Doctor] Um, and have you, and, how, how has your mood been over this period? Have you been feeling your usual self?\n[Patient] Um.\n[Patient] Distracted, , I'd say. Uh, I, I kind of, um. Yeah, uh, finding it really hard to, quite, difficult to keep focusing, I would say. Um, not unhappy or, happy, but just uh, quite, just , not focused.\n[Doctor] OK. So difficulty focusing, quite distracted. And, would you say you've been in good spirits? Or is your mood low?\n[Patient] Um. Actually uh, now you, you, you mention it like, my, mood is a bit lower recently. Um, and so I've noticed like, uh, my sex drive has kind of decreased, um, a bit over the, the past few months as well, so, yeah.\n[Doctor] Right.\n[Doctor] K. And uh, so lower mood, decreased sex drive recently as well. And, just on that note, just a few questions around that. Are you able to, uh, it may be slightly personal questions, but if you're O. O. K. to answer this, Do you tend to, to have morning erections like you, is that something that you've noticed, ?\n[Patient] Yeah.\n[Patient] Um, I haven't noticed anything like that, specifically, no.\n[Doctor] So, you've not, so you're saying you have not noticed morning erections, and usually you would. So, normal thing to have, uh, waking up in the morning with something. But you have not noticed those recently.\n[Patient] Yes.\n[Patient] I have not noticed those recently.\n[Doctor] OK. So, and that's been a change, has it?\n[Patient] Um.\n[Patient] Important one I don't think, um, yeah. Not, I don't think it's important to change, no.\n[Doctor] Sorry?\n[Doctor] Uh, so you, you, you, you don't think there's been a change there. You\n[Patient] No, there hasn't been a change there.\n[Doctor] Ohh OK, sorry. Right, so OK. So, um, Just going back to the mood symptoms as well. Uh, you have had uh, difficulty focusing, easily distracted. Your mood has been uh, slightly lower, with lower sex drive.\n[Patient] Yeah.\n[Patient] Yeah.\n[Doctor] Um, and in what way has your sex drive been lower? are you in a relationship at the moment?\n[Patient] Yeah, I, I'm married, um, have been for, many years.\n[Doctor] Mm-hmm.\n[Patient] And, uh, yeah just, um. Over the last few months, just uh, been disinterested.\n[Doctor] Disinterested.\n[Doctor] OK. OK. Sorry, you froze there for a moment. Um, . So less interested as well, OK.\n[Patient] \n[Patient] Yeah.\n[Doctor] And, just to ask you a few questions before we uh, wrap up is, uh, any significant past medical history? Um, so do you suffer from any, uh, mental health problems in the past, or any, uh, physical health problems? \n[Patient] Um, so, in the past, um, I have a, a history of, hypothyroidism, um.\n[Doctor] Hypo?\n[Patient] Hypothyroidism.\n[Doctor] Hyperthyroid.\n[Patient] Yeah.\n[Doctor] K, so that's high thyroid, just to sort of confirm that.\n[Patient] Um.\n[Patient] Sorry, can you say that again please?\n[Doctor] hyper, as in high, hyperthyroid.\n[Patient] Hypo.\n[Doctor] Hypo, OK. Hypothyroid. Thank you.\n[Patient] Thank you. Um. Yeah, and uh, also in the past, I mean, I haven't had any kind of specific, uh, medical diagnoses, along these lines.\n[Doctor] OK.\n[Patient] Um, but the suspicion, that it may have uh, had an impact on me, but my father has commited suicide, um, about fifteen years ago.\n[Doctor] OK. OK. And um,\n[Doctor] Uh, do you take any medications?\n[Patient] I had a, a, drug history of Thyroxine.\n[Doctor] Mm-hmm.\n[Patient] So, maybe, yes.\n[Doctor] Do you, do you continue to take Thyrocsin now?\n[Patient] Yes.\n[Doctor] You do. You're, so you're taking Thyrocsin at the moment?\n[Patient] Um.\n[Patient] Yes.\n[Doctor] Cool. And any drug allergies? Are you allergic to any medications?\n[Patient] No, I have no uh, medication allergies, no.\n[Doctor] No. No allergies. And you mentioned the , the suicide of your father fifteen years ago. I'm very sorry to hear that. Is there any other, um, uh, significant family history of medical conditions, or psychiatric conditions?\n[Patient] No.\n[Doctor] No depression or anything like that running in your family, or uh, \n[Patient] Uh, nothing, nothing, that sort.\n[Doctor] OK. And your mother is, is well? Any brothers or sisters?\n[Patient] Yeah she's fine, um, and no, I'm an only child. Um.\n[Doctor] Um, OK. So, I just uh, uh, sorry it might seem like a slightly random question, but any uh, change in vision? No \n[Patient] No, no, nothing like that.\n[Doctor] . OK. And, just to go back to your, you were saying you had low mood. Some people who , who do have low mood, uh, and low sex drive can sometimes feel uh, suicidal as well. Have you had any thoughts of harming yourself or harming anyone else?\n[Patient] No.\n[Doctor] No.\n[Patient] No, not , not really, no.\n[Doctor] and are you able to get the usual enjoyment out of your daily activities, that you have done in the past?\n[Patient] Sometimes, I mean, I guess, um, most of the activites, but, when I've been doing sports as well, , I find sometimes it's quite difficult to breathe, um. So, I have some kind of like, shortness of breath um, when doing, sports, compared to maybe a couple of months ago.\n[Doctor] OK. So you, you've become more short of breath over the last few months.\n[Patient] Yeah.\n[Doctor] Um, and you've had a OK. So uh, any other things around that? So, more fatigue, more shortness of breath, um, over the last few months?\n[Patient] Mmm.\n[Doctor] Um, with a low, lower mood, decreased sex drive. Um, is there, just before we wrap up, is there anything else that you would like to talk about?\n[Patient] Um, no, nothing specific, no.\n[Doctor] So, um, We're getting a little bit towards the end now, but I would quite like to make a bit more of a plan for you. Um, I would like to, probably see you in person, and do an examination. And, and also, we would probably like to do some blood tests um, as well. So, do you think it would be possible to see uh, to to book an appointment in the next few days uh, with your GP? Or, or um, that would be ideal, I think here. Um, and then we can, we can probably do some more uh, we'll do an examination and uh, do some investigations really, to see what's going on here a little bit more.\n[Patient] , yes.\n[Patient] That makes sense, yeah.\n[Doctor] Is that alright?\n[Patient] Yeah, that's very useful, thank you, um.\n[Doctor] OK.\n[Patient] Yeah, it feels, better to have some kind of plan, uh.\n[Doctor] Yeah. Yeah, yeah. I think , I definitely think we need a plan here. Um, it's been nice talking to you. I'm sorry, we've run out of time now. Uh, but we've at least started the ball rolling with um, some further investigations and tests. I'm glad you're, you know, you're, you're , you're, although you have a low mood, um, you're, you're, um, you're not feeling suicidal, just to confirm that.\n[Patient] Mm-hmm, yes.\n[Doctor] And, and you're, uh, and uh, we'll hopefully get to the bottom of some your tiredness, and your other symptoms, when we see you. OK?\n[Patient] Thank you very much, for taking the time. Thank you.\n[Doctor] OK. Thank you. Thanks.",
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"text": "Um, uh, and your date of birth.",
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"text": "Yeah, um. So basically it's, just been happening over the last few weeks or so. But I don't really feel like um, like, getting up in the morning's really difficult, and I don't have much energy at all, during the day, um. Often. Yeah just like, doing most things that I would normally find, easy , is become quite difficult.",
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"text": " OK. So, things have become quite difficult for you.",
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"text": "Um, no it's quite hard to say like. Things like, I'm not, I'm not eating very much at the moment. I just don't feel like I have a lot of energy.",
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"text": "OK. I'm sorry to hear that. Um, so you had difficulty waking up. No energy, not eating. And that's been going on for a few weeks. When you say a few weeks, do you mean two or three or five? how many hours of sleep? ",
"speaker": "Doctor"
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"text": "Actually, well, now I kind of think about it maybe, maybe even longer, um. I guess uh, , might be related to, so I also started a new job, um, slightly recently. Um. It might of even coincided, coincided with uh, with that, job, a couple of months ago.",
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"speaker": "Patient"
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"text": " OK. And, um, so this has been going on perhaps for um, sort of, six weeks or so?",
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"text": "More like, , two months, I would say, yeah.",
"speaker": "Patient"
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"text": "Well, um, I, I know that it's not really normal for me, so, before this phase. So I'd have thing, you know I wouldn't have, uh, any problems sort of. , eating, what I want to eat, or you know, doing standard things in life, and, and, what I want, to do is just like, kind of return to that previous state. Uh, somehow. Um, I'm not sure how that is. Uh, what, what the best ways of doing that are, but, yeah. Do you have some advice or?",
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"text": "OK. Sure. OK. Um, well what would I like to do is just ask you a few more, sort of questions around what's been going on, um, and also around your background health and um, and things like that. And then we can go on to sort of what can be done from there. Is that alright?",
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"text": "OK, great. so you say you've been, um, feeling unwell with not a lot of energy, difficult waking up in the mornings. Do you tend to just on that , do you tend to wake up early, and then stay in bed in the morning?",
"speaker": "Doctor"
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{
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"text": "Um, actually I'm, just uh, not, not really waking up early. It's more like I'm just having trouble sleeping at all, really. I think that's probably closer.",
"speaker": "Patient"
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"text": ", difficulty sleeping as well.",
"speaker": "Doctor"
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"text": "Yeah.",
"speaker": "Patient"
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"text": "Um, and have you, and, how, how has your mood been over this period? Have you been feeling your usual self?",
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"text": "Um.",
"speaker": "Patient"
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"text": "Distracted, , I'd say. Uh, I, I kind of, um. Yeah, uh, finding it really hard to, quite, difficult to keep focusing, I would say. Um, not unhappy or, happy, but just uh, quite, just , not focused.",
"speaker": "Patient"
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"text": "OK. So difficulty focusing, quite distracted. And, would you say you've been in good spirits? Or is your mood low?",
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"text": "Um. Actually uh, now you, you, you mention it like, my, mood is a bit lower recently. Um, and so I've noticed like, uh, my sex drive has kind of decreased, um, a bit over the, the past few months as well, so, yeah.",
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"text": "K. And uh, so lower mood, decreased sex drive recently as well. And, just on that note, just a few questions around that. Are you able to, uh, it may be slightly personal questions, but if you're O. O. K. to answer this, Do you tend to, to have morning erections like you, is that something that you've noticed, ?",
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"text": "Yeah.",
"speaker": "Patient"
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"text": "Um, I haven't noticed anything like that, specifically, no.",
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"text": "So, you've not, so you're saying you have not noticed morning erections, and usually you would. So, normal thing to have, uh, waking up in the morning with something. But you have not noticed those recently.",
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"text": "Yes.",
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"text": "I have not noticed those recently.",
"speaker": "Patient"
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"text": "OK. So, and that's been a change, has it?",
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"text": "Um.",
"speaker": "Patient"
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"text": "Important one I don't think, um, yeah. Not, I don't think it's important to change, no.",
"speaker": "Patient"
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"text": "Sorry?",
"speaker": "Doctor"
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"text": "Ohh OK, sorry. Right, so OK. So, um, Just going back to the mood symptoms as well. Uh, you have had uh, difficulty focusing, easily distracted. Your mood has been uh, slightly lower, with lower sex drive.",
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"text": "Yeah.",
"speaker": "Patient"
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"text": "Yeah.",
"speaker": "Patient"
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"text": "Um, and in what way has your sex drive been lower? are you in a relationship at the moment?",
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"text": "Yeah, I, I'm married, um, have been for, many years.",
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"text": "Mm-hmm.",
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"text": "And, uh, yeah just, um. Over the last few months, just uh, been disinterested.",
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"text": "OK. OK. Sorry, you froze there for a moment. Um, . So less interested as well, OK.",
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"text": "Yeah.",
"speaker": "Patient"
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"text": "And, just to ask you a few questions before we uh, wrap up is, uh, any significant past medical history? Um, so do you suffer from any, uh, mental health problems in the past, or any, uh, physical health problems? ",
"speaker": "Doctor"
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{
"start": 422.98353,
"end": 431.28425,
"text": "Um, so, in the past, um, I have a, a history of, hypothyroidism, um.",
"speaker": "Patient"
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"start": 431.07758,
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"text": "Hypo?",
"speaker": "Doctor"
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"text": "Hypothyroidism.",
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"text": "Hyperthyroid.",
"speaker": "Doctor"
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{
"start": 437.63762,
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"text": "Yeah.",
"speaker": "Patient"
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{
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"end": 442.05781,
"text": "K, so that's high thyroid, just to sort of confirm that.",
"speaker": "Doctor"
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{
"start": 439.15478,
"end": 439.89659,
"text": "Um.",
"speaker": "Patient"
},
{
"start": 442.65894,
"end": 444.35941,
"text": "Sorry, can you say that again please?",
"speaker": "Patient"
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{
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"text": " hyper, as in high, hyperthyroid.",
"speaker": "Doctor"
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"end": 448.71468,
"text": "Hypo.",
"speaker": "Patient"
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"text": "Hypo, OK. Hypothyroid. Thank you.",
"speaker": "Doctor"
},
{
"start": 452.36691,
"end": 465.11897,
"text": "Thank you. Um. Yeah, and uh, also in the past, I mean, I haven't had any kind of specific, uh, medical diagnoses, along these lines.",
"speaker": "Patient"
},
{
"start": 455.87337,
"end": 456.54469,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 465.11897,
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"text": "Um, but the suspicion, that it may have uh, had an impact on me, but my father has commited suicide, um, about fifteen years ago.",
"speaker": "Patient"
},
{
"start": 476.40914,
"end": 480.74177,
"text": "OK. OK. And um,",
"speaker": "Doctor"
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"end": 485.49554,
"text": "Uh, do you take any medications?",
"speaker": "Doctor"
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"text": "I had a, a, drug history of Thyroxine.",
"speaker": "Patient"
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"text": "Mm-hmm.",
"speaker": "Doctor"
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"start": 493.28406,
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"text": "So, maybe, yes.",
"speaker": "Patient"
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"text": "Do you, do you continue to take Thyrocsin now?",
"speaker": "Doctor"
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"text": "Yes.",
"speaker": "Patient"
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{
"start": 502.40902,
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"text": "You do. You're, so you're taking Thyrocsin at the moment?",
"speaker": "Doctor"
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{
"start": 506.69655,
"end": 507.66748,
"text": "Um.",
"speaker": "Patient"
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{
"start": 510.7201,
"end": 511.56221,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 511.831,
"end": 515.63609,
"text": "Cool. And any drug allergies? Are you allergic to any medications?",
"speaker": "Doctor"
},
{
"start": 515.44089,
"end": 519.13439,
"text": "No, I have no uh, medication allergies, no.",
"speaker": "Patient"
},
{
"start": 517.52174,
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"text": "No. No allergies. And you mentioned the , the suicide of your father fifteen years ago. I'm very sorry to hear that. Is there any other, um, uh, significant family history of medical conditions, or psychiatric conditions?",
"speaker": "Doctor"
},
{
"start": 533.68995,
"end": 534.40424,
"text": "No.",
"speaker": "Patient"
},
{
"start": 534.6919,
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"text": "No depression or anything like that running in your family, or uh, ",
"speaker": "Doctor"
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"text": "Uh, nothing, nothing, that sort.",
"speaker": "Patient"
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"start": 539.87501,
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"text": "OK. And your mother is, is well? Any brothers or sisters?",
"speaker": "Doctor"
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{
"start": 543.93052,
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"text": "Yeah she's fine, um, and no, I'm an only child. Um.",
"speaker": "Patient"
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{
"start": 550.9304,
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"text": "Um, OK. So, I just uh, uh, sorry it might seem like a slightly random question, but any uh, change in vision? No ",
"speaker": "Doctor"
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"text": "No, no, nothing like that.",
"speaker": "Patient"
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{
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"text": ". OK. And, just to go back to your, you were saying you had low mood. Some people who , who do have low mood, uh, and low sex drive can sometimes feel uh, suicidal as well. Have you had any thoughts of harming yourself or harming anyone else?",
"speaker": "Doctor"
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{
"start": 577.75747,
"end": 578.51687,
"text": "No.",
"speaker": "Patient"
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{
"start": 578.64023,
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"text": "No.",
"speaker": "Doctor"
},
{
"start": 579.59205,
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"text": "No, not , not really, no.",
"speaker": "Patient"
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{
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"text": " and are you able to get the usual enjoyment out of your daily activities, that you have done in the past?",
"speaker": "Doctor"
},
{
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"text": "Sometimes, I mean, I guess, um, most of the activites, but, when I've been doing sports as well, , I find sometimes it's quite difficult to breathe, um. So, I have some kind of like, shortness of breath um, when doing, sports, compared to maybe a couple of months ago.",
"speaker": "Patient"
},
{
"start": 606.95875,
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"text": "OK. So you, you've become more short of breath over the last few months.",
"speaker": "Doctor"
},
{
"start": 610.93029,
"end": 611.68969,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 611.49618,
"end": 623.6459,
"text": "Um, and you've had a OK. So uh, any other things around that? So, more fatigue, more shortness of breath, um, over the last few months?",
"speaker": "Doctor"
},
{
"start": 623.72568,
"end": 624.40527,
"text": "Mmm.",
"speaker": "Patient"
},
{
"start": 624.3434,
"end": 632.77673,
"text": "Um, with a low, lower mood, decreased sex drive. Um, is there, just before we wrap up, is there anything else that you would like to talk about?",
"speaker": "Doctor"
},
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"text": "Um, no, nothing specific, no.",
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"text": "So, um, We're getting a little bit towards the end now, but I would quite like to make a bit more of a plan for you. Um, I would like to, probably see you in person, and do an examination. And, and also, we would probably like to do some blood tests um, as well. So, do you think it would be possible to see uh, to to book an appointment in the next few days uh, with your GP? Or, or um, that would be ideal, I think here. Um, and then we can, we can probably do some more uh, we'll do an examination and uh, do some investigations really, to see what's going on here a little bit more.",
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"text": ", yes.",
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"text": "That makes sense, yeah.",
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"text": "Is that alright?",
"speaker": "Doctor"
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"text": "Yeah, that's very useful, thank you, um.",
"speaker": "Patient"
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"text": "OK.",
"speaker": "Doctor"
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"text": "Yeah, it feels, better to have some kind of plan, uh.",
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"text": "Yeah. Yeah, yeah. I think , I definitely think we need a plan here. Um, it's been nice talking to you. I'm sorry, we've run out of time now. Uh, but we've at least started the ball rolling with um, some further investigations and tests. I'm glad you're, you know, you're, you're , you're, although you have a low mood, um, you're, you're, um, you're not feeling suicidal, just to confirm that.",
"speaker": "Doctor"
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"text": "Mm-hmm, yes.",
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"text": "And, and you're, uh, and uh, we'll hopefully get to the bottom of some your tiredness, and your other symptoms, when we see you. OK?",
"speaker": "Doctor"
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"text": "Thank you very much, for taking the time. Thank you.",
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"text": "OK. Thank you. Thanks.",
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"doctor_utterances": " Hello. Hi! Hi there. Uh, my name's Joe. I'm one of the doctors at Babylon. I, just, can I confirm your name please? Makes sense. Yeah. So, . Sorry, your name is? Brian. Hi Brian. Nice to Um, uh, and your date of birth. Great. And uh, are you in a sort of, uh, confidential place where you can speak freely? Great. And you're happy to continue with the consultation. Marvelous. OK. So, um, how can i help today? OK. So, things have become quite difficult for you. Is there anything else? OK. I'm sorry to hear that. Um, so you had difficulty waking up. No energy, not eating. And that's been going on for a few weeks. When you say a few weeks, do you mean two or three or five? how many hours of sleep? When did you start your new job? Two months ago, did you say? OK. And, um, so this has been going on perhaps for um, sort of, six weeks or so? OK. Alright. So, um, Is there anything that you're particularly, sort of concerned about, um, or hoping to get out of this consultation? OK. Sure. OK. Um, well what would I like to do is just ask you a few more, sort of questions around what's been going on, um, and also around your background health and um, and things like that. And then we can go on to sort of what can be done from there. Is that alright? OK, great. so you say you've been, um, feeling unwell with not a lot of energy, difficult waking up in the mornings. Do you tend to just on that , do you tend to wake up early, and then stay in bed in the morning? , difficulty sleeping as well. Um, and have you, and, how, how has your mood been over this period? Have you been feeling your usual self? OK. So difficulty focusing, quite distracted. And, would you say you've been in good spirits? Or is your mood low? Right. K. And uh, so lower mood, decreased sex drive recently as well. And, just on that note, just a few questions around that. Are you able to, uh, it may be slightly personal questions, but if you're O. O. K. to answer this, Do you tend to, to have morning erections like you, is that something that you've noticed, ? So, you've not, so you're saying you have not noticed morning erections, and usually you would. So, normal thing to have, uh, waking up in the morning with something. But you have not noticed those recently. OK. So, and that's been a change, has it? Sorry? Uh, so you, you, you, you don't think there's been a change there. You Ohh OK, sorry. Right, so OK. So, um, Just going back to the mood symptoms as well. Uh, you have had uh, difficulty focusing, easily distracted. Your mood has been uh, slightly lower, with lower sex drive. Um, and in what way has your sex drive been lower? are you in a relationship at the moment? Mm-hmm. Disinterested. OK. OK. Sorry, you froze there for a moment. Um, . So less interested as well, OK. And, just to ask you a few questions before we uh, wrap up is, uh, any significant past medical history? Um, so do you suffer from any, uh, mental health problems in the past, or any, uh, physical health problems? Hypo? Hyperthyroid. K, so that's high thyroid, just to sort of confirm that. hyper, as in high, hyperthyroid. Hypo, OK. Hypothyroid. Thank you. OK. OK. OK. And um, Uh, do you take any medications? Mm-hmm. Do you, do you continue to take Thyrocsin now? You do. You're, so you're taking Thyrocsin at the moment? Cool. And any drug allergies? Are you allergic to any medications? No. No allergies. And you mentioned the , the suicide of your father fifteen years ago. I'm very sorry to hear that. Is there any other, um, uh, significant family history of medical conditions, or psychiatric conditions? No depression or anything like that running in your family, or uh, OK. And your mother is, is well? Any brothers or sisters? Um, OK. So, I just uh, uh, sorry it might seem like a slightly random question, but any uh, change in vision? No . OK. And, just to go back to your, you were saying you had low mood. Some people who , who do have low mood, uh, and low sex drive can sometimes feel uh, suicidal as well. Have you had any thoughts of harming yourself or harming anyone else? No. and are you able to get the usual enjoyment out of your daily activities, that you have done in the past? OK. So you, you've become more short of breath over the last few months. Um, and you've had a OK. So uh, any other things around that? So, more fatigue, more shortness of breath, um, over the last few months? Um, with a low, lower mood, decreased sex drive. Um, is there, just before we wrap up, is there anything else that you would like to talk about? So, um, We're getting a little bit towards the end now, but I would quite like to make a bit more of a plan for you. Um, I would like to, probably see you in person, and do an examination. And, and also, we would probably like to do some blood tests um, as well. So, do you think it would be possible to see uh, to to book an appointment in the next few days uh, with your GP? Or, or um, that would be ideal, I think here. Um, and then we can, we can probably do some more uh, we'll do an examination and uh, do some investigations really, to see what's going on here a little bit more. Is that alright? OK. Yeah. Yeah, yeah. I think , I definitely think we need a plan here. Um, it's been nice talking to you. I'm sorry, we've run out of time now. Uh, but we've at least started the ball rolling with um, some further investigations and tests. I'm glad you're, you know, you're, you're , you're, although you have a low mood, um, you're, you're, um, you're not feeling suicidal, just to confirm that. And, and you're, uh, and uh, we'll hopefully get to the bottom of some your tiredness, and your other symptoms, when we see you. OK? OK. Thank you. Thanks.",
"patient_utterances": "Hi there. , yeah. Uh, my name's . Name was Brian. Hi. Yeah, my date of birth is the eighth of August, nineteen eighty two. Yeah. No, no one else can hear me. Yes. Yeah, um. So basically it's, just been happening over the last few weeks or so. But I don't really feel like um, like, getting up in the morning's really difficult, and I don't have much energy at all, during the day, um. Often. Yeah just like, doing most things that I would normally find, easy , is become quite difficult. Yeah. Um, no it's quite hard to say like. Things like, I'm not, I'm not eating very much at the moment. I just don't feel like I have a lot of energy. Actually, well, now I kind of think about it maybe, maybe even longer, um. I guess uh, , might be related to, so I also started a new job, um, slightly recently. Um. It might of even coincided, coincided with uh, with that, job, a couple of months ago. Yeah. More like, , two months, I would say, yeah. Well, um, I, I know that it's not really normal for me, so, before this phase. So I'd have thing, you know I wouldn't have, uh, any problems sort of. , eating, what I want to eat, or you know, doing standard things in life, and, and, what I want, to do is just like, kind of return to that previous state. Uh, somehow. Um, I'm not sure how that is. Uh, what, what the best ways of doing that are, but, yeah. Do you have some advice or? Whatever, that'd be really useful. OK. Um, actually I'm, just uh, not, not really waking up early. It's more like I'm just having trouble sleeping at all, really. I think that's probably closer. Yeah. Um. Distracted, , I'd say. Uh, I, I kind of, um. Yeah, uh, finding it really hard to, quite, difficult to keep focusing, I would say. Um, not unhappy or, happy, but just uh, quite, just , not focused. Um. Actually uh, now you, you, you mention it like, my, mood is a bit lower recently. Um, and so I've noticed like, uh, my sex drive has kind of decreased, um, a bit over the, the past few months as well, so, yeah. Yeah. Um, I haven't noticed anything like that, specifically, no. Yes. I have not noticed those recently. Um. Important one I don't think, um, yeah. Not, I don't think it's important to change, no. No, there hasn't been a change there. Yeah. Yeah. Yeah, I, I'm married, um, have been for, many years. And, uh, yeah just, um. Over the last few months, just uh, been disinterested. Yeah. Um, so, in the past, um, I have a, a history of, hypothyroidism, um. Hypothyroidism. Yeah. Um. Sorry, can you say that again please? Hypo. Thank you. Um. Yeah, and uh, also in the past, I mean, I haven't had any kind of specific, uh, medical diagnoses, along these lines. Um, but the suspicion, that it may have uh, had an impact on me, but my father has commited suicide, um, about fifteen years ago. I had a, a, drug history of Thyroxine. So, maybe, yes. Yes. Um. Yes. No, I have no uh, medication allergies, no. No. Uh, nothing, nothing, that sort. Yeah she's fine, um, and no, I'm an only child. Um. No, no, nothing like that. No. No, not , not really, no. Sometimes, I mean, I guess, um, most of the activites, but, when I've been doing sports as well, , I find sometimes it's quite difficult to breathe, um. So, I have some kind of like, shortness of breath um, when doing, sports, compared to maybe a couple of months ago. Yeah. Mmm. Um, no, nothing specific, no. , yes. That makes sense, yeah. Yeah, that's very useful, thank you, um. Yeah, it feels, better to have some kind of plan, uh. Mm-hmm, yes. Thank you very much, for taking the time. Thank you.",
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"reference_note": "{\"day\": 4, \"consultation\": 8, \"presenting_complaint\": \"lately, I haven't had much appetite or energy\", \"note\": \"Confirmed name \\nDOB confrimed. \\n\\n\\n8 weeks. \\nNot able to get up in the morning \\nNo energy during the day. \\nNot eating \\nDifficulty sleeping. \\nMood is Distracted difficulty focusing. \\nLower mood recently \\nDecreased sex drive. \\nNo suicidal ideation \\n\\nNew job - 2 months ago. \\n\\nICE - would like to get back to how he was. \\n\\n\\nMarried - \\n\\nPMHx - Hypothyroidism. \\n\\nDHx - Thyroxine.\\n\\nNKDA \\n\\nShx - \\n\\nFhx \\nFather - suicide. \\nMother well \\nNo brothers or sisters. \\n\\nImp- depression. Hypothyroidism. (Low T3/4) \\n\\nPlan \\nTSH, FBC, \\nExamination \\nGP review. \\n\", \"highlights\": [\"\"]}",
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"dialogue": "[Patient] Hello.\n[Doctor] Ohh hello. Hi, how you doing? Uh, my name's Joe. I'm one of the doctors here at Babylon. Can I just confirm your name please?\n[Patient] Hi.\n[Doctor] Yes. Brian .\n[Patient] Yeah, sure. My name's Daniel .\n[Doctor] Hi Daniel. And your date of birth? .\n[Patient] Yeah. May . Nineteen ninety two.\n[Doctor] Ninety two. OK, Daniel. And uh, are you in a, a comfortable and confidential place to talk?\n[Patient] Yeah. Totally.\n[Doctor] , happy to go ahead. Great. How can I help?\n[Patient] Um, yeah, I just, my chest has been feeling really tight.\n[Doctor] OK. And how long has this been going on for Daniel?\n[Patient] Uh, for about. Three hours now.\n[Doctor] OK. And, so, tight chest, three hours. Um, and, so you're born in ninety two, so that makes you twenty six? Um, and, you are, uh. Any shortness of breath at all, with that?\n[Patient] Twenty six, yeah.\n[Patient] Yeah, like a little bit, um. Yeah, a little bit short of breath, not too bad.\n[Doctor] Uh, any cough? Wheeze?\n[Patient] Yeah, I'm feeling a bit wheezy, as well. Kind of cough , coughing, yeah.\n[Doctor] Slight cough, yeah. , sore throat? Runny nose? Sore ears?\n[Patient] Yeah.\n[Patient] You know I had a cold last week, and, it's not as bad as it was, but yeah, I had a sore throat, I had a runny nose. Uh, just feeling under the weather.\n[Doctor] Mm-hmm. Are you feeling better now, other than the tight chest?\n[Patient] I mean I feel worse, but the runny nose isn't as bad any more. .\n[Doctor] Right. OK, OK, but you now, now you've got this, this um. So you've still got, still got uh, symptoms of a cold, essentially?\n[Patient] Yeah, but the cough's kind of stuck around.\n[Doctor] Uh, ooh, yeah, OK.\n[Doctor] And are you coughing up anything?\n[Patient] Uh, no.\n[Doctor] And, um, do you have any other medical problems, like asthma?\n[Patient] Yeah, yeah, I have asthma, I've had it for a while now, um. And then I have like, a hayfever, you know, and some allergies just to dust, stuff like that.\n[Doctor] , OK. You have any, inhalers? Or any, any medications?\n[Patient] Um, yeah, so, uh, you know the um, uh, Ventolin. It's called uh, Salbutamol.\n[Doctor] Yeah.\n[Patient] I got that one, and then I have a steroid, a Clenil, Clenil inhaler.\n[Doctor] Clenil, Clenil Modulite, yeah, OK.\n[Patient] Yeah, yeah.\n[Doctor] And um, uh, have you been using Clenil and the Ventolin? And how often have you been using them?\n[Patient] Um, well to be honest, I was away at uni last week, and I forgot to bring it with me, so I haven't really in the past week. Uh.\n[Doctor] Both of them?\n[Patient] Because , because um, sorry, they ran out and I, I forgot to, go and grab the next one.\n[Doctor] Yeah, sure.\n[Patient] About a week ago. Yeah.\n[Doctor] OK. All right, all right. So, so, so you've, you haven't got any Clenil, or any Ventolin at the moment?\n[Patient] Not with me right now, no, I ran out.\n[Doctor] OK. All right. Um, and , any drug allergies, that you know of?\n[Patient] No, no, not allergic to anything. Just like, just the, dust and stuff, but nothing, no drugs.\n[Doctor] OK, great. Now, uh, do you, anyone in your family have any medical problems, that you know of?\n[Patient] Um, yeah, my mum has eczema, and my dad has asthma. , ohh, when I was young, I also had eczema. And I had a milk protein allergy, when I was young too.\n[Doctor] Hmm. OK. Um. Right. So, just uh, , do you have any other, sort of concerns? Or ideas about what might be going on? Or, um, hopes for this consultation?\n[Patient] Um. Not really, like I feel like asthma's probably a part of it, and, probably getting my, inhalers would be helpful Um. It's just kinda scary, 'cause I haven't had, a time like this where I've been so, tight, uh, in a long time.\n[Doctor] Yeah, absolutely, I can, I can imagine. Um, well, it certainly sounds like uh, you've, you've had this cold, so you've got wheezy with a cough. Um, and it's non-productive cough, and you're short of breath. Uh, is the cough worse at night-time?\n[Patient] I mean, it gets a little bit worse at night but, basically, just pretty consistent, and it hasn't gone away.\n[Doctor] Yeah. OK. And you've got this tight, tight chest. But you, you wouldn't say you've got chest pains? It's more of a tight chest, is it?\n[Patient] No, not really pain, it's more like, tight. It just feels like sometimes, I can't get a full breath in, you know.\n[Doctor] Yeah, sure. Um, OK. Well, I, I would quite like to, uh, certainly get you some, uh, Ventolin, Clenil Modulite. Have you had asthma exacerbations in the past?\n[Patient] Not in a long time. When I was young, a little bit, more like, back in high school. Um, but, I've been pretty good at taking my , my inhalers, so, not, not so much any more.\n[Doctor] Yeah.\n[Doctor] Have you ever been to hospital, uh, as an inpatient? As in, you know, stayed in there overnight, for asthma?\n[Patient] Yeah, when I was in high school, I had to have a tube put down my throat.\n[Doctor] Ohh, OK. So you, so, so you, uh, you , you went to hospital, and had a, a, . So you stayed in hospital for a few days did you, with an asthma exacerbation?\n[Patient] Yeah I did, yeah.\n[Doctor] OK, but currently you're just on Ventolin and Clenil? And you haven't got any of those steroids, uh, those inhalers at the moment?\n[Patient] Yeah, I'm doing pretty good, I'm doing pretty good, just on the Clenil, and the Salbutamol.\n[Doctor] OK. When, sorry, how old were you when you had that severe asthma exacerbation?\n[Patient] Uh, I think I was like seventeen. Sixteen maybe.\n[Doctor] Sure. OK. Um.\n[Doctor] Just to quantify how short of breath you are, um, I don't suppose you've got a peak flow with you? No, you won't have will you.\n[Patient] No, no.\n[Doctor] Um, are you able to, uh, like walk up, flights of stairs OK? Walk on the flat OK, without getting to short of breath? Or um, are you short of breath at rest?\n[Patient] Uh, I'm definitely not short of breath at rest, like, except for that feeling I was describing. It does when I'm walking up stairs, I do feel like, I have a little bit, more short of breath than I would normally be.\n[Doctor] Sure. Yeah. OK, but you're not short of breath at rest at the moment?\n[Patient] No, no, no I'm not.\n[Doctor] OK, fine. So, what, what I think, um, and just to, just to go over, . Is there anything you had hoped about getting other than the uh, a, prescription for your inhalers? Was there anything else you'd hoped about getting from this?\n[Patient] Well I just wanna know that I'm OK, to just like keep. I just don't wanna have to get, um, that, that intubation again.\n[Doctor] Sure, yeah, no, absolutely. Well, I'm really glad you have talked to me today. I think what we can do is, is give you a prescription for, uh, some more of the inhalers. We can get that to you, within the hour, I would hope.\n[Patient] Uh, .\n[Doctor] Um, and, uh, I think, what, the other thing I'd like to do is just give you a, dose of steroids. So this is, these are tablets which, um, you can take for five days. Uh, two tablets in the morning. And, uh, that should just dampen down your asthmatic response, OK.\n[Patient] OK.\n[Doctor] Um, now there are some side effects to the steroids. Which I should really tell you about, but please read the label, that's associated with. Don't be too worried about the side effects. They're , most, you know , most of the time the steroids are, very well tolerated. And, uh, you . Have you had them in the past, do you know of?\n[Patient] Sorry, sorry, you were cutting in and out a little bit there. What were you saying?\n[Doctor] . Have you had steroids in the past?\n[Patient] Um, I can't remember, probably. I think so.\n[Doctor] Probably, yeah I would too. So, um, they, they can come, they can make you, your mood change, can be slightly low or too, slightly high. Can give you, a high blood sugar, um, and, uh, their. Uh, , they can also cause rash, nausea, um, headaches, but, mostly is well-tolerated, and it should help your asthma an awful lot. Um, uh, what I'd like to do is, is send you these, the, some prescriptions for your, uh, inhalers, , ongoing. So you, um, you can, once you get better from this asthma attack, you can, you can, use the Clenil Modulite in the morning, with Ventolin as a PRN. , so, a Ventolin when you need to, um, when you're getting wheezy.\n[Patient] OK.\n[Patient] OK.\n[Doctor] If you should start to use the Ventolin more than, uh, every three hours. Uh, at, at anytime, it's a good idea to seek medical attention. So, um, see a doctor, um, in some capacity.\n[Patient] Yeah.\n[Doctor] Uh, and, the other thing I'd like to send you is a spacer, which would allow the medication to actually, go into your lungs better. Have you, do you know what a spacer is? Have you used one before?\n[Patient] Yeah, yeah, I, somebody told me how to use one a while ago. I don't, I don't really use it, to be honest, but.\n[Doctor] Have you got one?\n[Patient] I think I do, I have one somewhere.\n[Doctor] OK. All right. Well, um, I'll send you another one, and it has some instructions about how to use it, but essentially, uh, couple of puffs to prime it, inside, breathing in and out, um, uh, for five or , five or ten breaths.\n[Patient] OK.\n[Doctor] Uh, yeah. So. Uh, was there anything else that was on your mind? Or you're concerned about at this stage?\n[Patient] , I think you got me covered.\n[Doctor] OK, and, and uh, I might give you some time off work as well. You can self-certify first seven days, but uh, I think I would advise you just to, rest a little bit until you're feeling a bit better, if you're OK with that. All right?\n[Patient] OK, . All righty. Well, thank you very much.\n[Doctor] OK. No worries. Any deterioration in your symptoms, like worsening shortness of breath. Um, or just generally concerning symptoms, uh, pain in your chest tightness, uh, feeling light-headed. Uh, then, seek further medical attention anytime please. OK?\n[Patient] All right, sounds good.\n[Doctor] OK. Thank you.\n[Patient] OK, thank you. Bye bye.\n[Doctor] Bye bye.",
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"text": "Yeah, I'm feeling a bit wheezy, as well. Kind of cough , coughing, yeah.",
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"text": "Slight cough, yeah. , sore throat? Runny nose? Sore ears?",
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"text": "You know I had a cold last week, and, it's not as bad as it was, but yeah, I had a sore throat, I had a runny nose. Uh, just feeling under the weather.",
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{
"start": 91.01818,
"end": 96.40304,
"text": "I mean I feel worse, but the runny nose isn't as bad any more. .",
"speaker": "Patient"
},
{
"start": 95.59444,
"end": 102.82756,
"text": "Right. OK, OK, but you now, now you've got this, this um. So you've still got, still got uh, symptoms of a cold, essentially?",
"speaker": "Doctor"
},
{
"start": 102.85945,
"end": 104.71851,
"text": "Yeah, but the cough's kind of stuck around.",
"speaker": "Patient"
},
{
"start": 105.11328,
"end": 107.45164,
"text": "Uh, ooh, yeah, OK.",
"speaker": "Doctor"
},
{
"start": 110.05315,
"end": 111.6321,
"text": "And are you coughing up anything?",
"speaker": "Doctor"
},
{
"start": 112.24203,
"end": 113.06753,
"text": "Uh, no.",
"speaker": "Patient"
},
{
"start": 114.97451,
"end": 119.42544,
"text": "And, um, do you have any other medical problems, like asthma?",
"speaker": "Doctor"
},
{
"start": 119.84679,
"end": 129.90654,
"text": "Yeah, yeah, I have asthma, I've had it for a while now, um. And then I have like, a hayfever, you know, and some allergies just to dust, stuff like that.",
"speaker": "Patient"
},
{
"start": 128.52692,
"end": 135.88785,
"text": ", OK. You have any, inhalers? Or any, any medications?",
"speaker": "Doctor"
},
{
"start": 136.82072,
"end": 143.05425,
"text": "Um, yeah, so, uh, you know the um, uh, Ventolin. It's called uh, Salbutamol.",
"speaker": "Patient"
},
{
"start": 143.35405,
"end": 144.32398,
"text": "Yeah.",
"speaker": "Doctor"
},
{
"start": 144.38601,
"end": 148.86575,
"text": "I got that one, and then I have a steroid, a Clenil, Clenil inhaler.",
"speaker": "Patient"
},
{
"start": 149.03077,
"end": 151.66373,
"text": "Clenil, Clenil Modulite, yeah, OK.",
"speaker": "Doctor"
},
{
"start": 151.04897,
"end": 152.2422,
"text": "Yeah, yeah.",
"speaker": "Patient"
},
{
"start": 152.4952,
"end": 159.72723,
"text": "And um, uh, have you been using Clenil and the Ventolin? And how often have you been using them?",
"speaker": "Doctor"
},
{
"start": 159.67762,
"end": 169.36979,
"text": "Um, well to be honest, I was away at uni last week, and I forgot to bring it with me, so I haven't really in the past week. Uh.",
"speaker": "Patient"
},
{
"start": 168.20378,
"end": 169.79777,
"text": "Both of them?",
"speaker": "Doctor"
},
{
"start": 170.96631,
"end": 175.05927,
"text": "Because , because um, sorry, they ran out and I, I forgot to, go and grab the next one.",
"speaker": "Patient"
},
{
"start": 174.79028,
"end": 176.20381,
"text": "Yeah, sure.",
"speaker": "Doctor"
},
{
"start": 175.76451,
"end": 177.73895,
"text": "About a week ago. Yeah.",
"speaker": "Patient"
},
{
"start": 177.09103,
"end": 183.02339,
"text": "OK. All right, all right. So, so, so you've, you haven't got any Clenil, or any Ventolin at the moment?",
"speaker": "Doctor"
},
{
"start": 183.38327,
"end": 185.5108,
"text": "Not with me right now, no, I ran out.",
"speaker": "Patient"
},
{
"start": 185.53468,
"end": 191.96328,
"text": "OK. All right. Um, and , any drug allergies, that you know of?",
"speaker": "Doctor"
},
{
"start": 192.21618,
"end": 198.72928,
"text": "No, no, not allergic to anything. Just like, just the, dust and stuff, but nothing, no drugs.",
"speaker": "Patient"
},
{
"start": 198.78286,
"end": 205.15884,
"text": "OK, great. Now, uh, do you, anyone in your family have any medical problems, that you know of?",
"speaker": "Doctor"
},
{
"start": 205.20356,
"end": 216.22906,
"text": "Um, yeah, my mum has eczema, and my dad has asthma. , ohh, when I was young, I also had eczema. And I had a milk protein allergy, when I was young too.",
"speaker": "Patient"
},
{
"start": 216.35438,
"end": 232.46724,
"text": "Hmm. OK. Um. Right. So, just uh, , do you have any other, sort of concerns? Or ideas about what might be going on? Or, um, hopes for this consultation?",
"speaker": "Doctor"
},
{
"start": 232.06135,
"end": 250.7527,
"text": "Um. Not really, like I feel like asthma's probably a part of it, and, probably getting my, inhalers would be helpful Um. It's just kinda scary, 'cause I haven't had, a time like this where I've been so, tight, uh, in a long time.",
"speaker": "Patient"
},
{
"start": 251.21923,
"end": 267.64037,
"text": "Yeah, absolutely, I can, I can imagine. Um, well, it certainly sounds like uh, you've, you've had this cold, so you've got wheezy with a cough. Um, and it's non-productive cough, and you're short of breath. Uh, is the cough worse at night-time?",
"speaker": "Doctor"
},
{
"start": 268.8176,
"end": 274.36355,
"text": "I mean, it gets a little bit worse at night but, basically, just pretty consistent, and it hasn't gone away.",
"speaker": "Patient"
},
{
"start": 273.06897,
"end": 282.18439,
"text": "Yeah. OK. And you've got this tight, tight chest. But you, you wouldn't say you've got chest pains? It's more of a tight chest, is it?",
"speaker": "Doctor"
},
{
"start": 281.87731,
"end": 289.06832,
"text": "No, not really pain, it's more like, tight. It just feels like sometimes, I can't get a full breath in, you know.",
"speaker": "Patient"
},
{
"start": 289.09911,
"end": 302.06911,
"text": "Yeah, sure. Um, OK. Well, I, I would quite like to, uh, certainly get you some, uh, Ventolin, Clenil Modulite. Have you had asthma exacerbations in the past?",
"speaker": "Doctor"
},
{
"start": 302.43751,
"end": 313.75971,
"text": "Not in a long time. When I was young, a little bit, more like, back in high school. Um, but, I've been pretty good at taking my , my inhalers, so, not, not so much any more.",
"speaker": "Patient"
},
{
"start": 308.61801,
"end": 309.28718,
"text": "Yeah.",
"speaker": "Doctor"
},
{
"start": 313.66314,
"end": 319.44513,
"text": "Have you ever been to hospital, uh, as an inpatient? As in, you know, stayed in there overnight, for asthma?",
"speaker": "Doctor"
},
{
"start": 319.63893,
"end": 322.98498,
"text": "Yeah, when I was in high school, I had to have a tube put down my throat.",
"speaker": "Patient"
},
{
"start": 323.13095,
"end": 334.84544,
"text": "Ohh, OK. So you, so, so you, uh, you , you went to hospital, and had a, a, . So you stayed in hospital for a few days did you, with an asthma exacerbation?",
"speaker": "Doctor"
},
{
"start": 334.8135,
"end": 335.86048,
"text": "Yeah I did, yeah.",
"speaker": "Patient"
},
{
"start": 335.76852,
"end": 341.52794,
"text": "OK, but currently you're just on Ventolin and Clenil? And you haven't got any of those steroids, uh, those inhalers at the moment?",
"speaker": "Doctor"
},
{
"start": 341.88064,
"end": 345.80683,
"text": "Yeah, I'm doing pretty good, I'm doing pretty good, just on the Clenil, and the Salbutamol.",
"speaker": "Patient"
},
{
"start": 345.67834,
"end": 350.90393,
"text": "OK. When, sorry, how old were you when you had that severe asthma exacerbation?",
"speaker": "Doctor"
},
{
"start": 351.09545,
"end": 355.99478,
"text": "Uh, I think I was like seventeen. Sixteen maybe.",
"speaker": "Patient"
},
{
"start": 356.37713,
"end": 360.33934,
"text": "Sure. OK. Um.",
"speaker": "Doctor"
},
{
"start": 363.20473,
"end": 369.83602,
"text": "Just to quantify how short of breath you are, um, I don't suppose you've got a peak flow with you? No, you won't have will you.",
"speaker": "Doctor"
},
{
"start": 369.46465,
"end": 370.62572,
"text": "No, no.",
"speaker": "Patient"
},
{
"start": 369.83602,
"end": 381.41536,
"text": "Um, are you able to, uh, like walk up, flights of stairs OK? Walk on the flat OK, without getting to short of breath? Or um, are you short of breath at rest?",
"speaker": "Doctor"
},
{
"start": 381.96135,
"end": 392.46475,
"text": "Uh, I'm definitely not short of breath at rest, like, except for that feeling I was describing. It does when I'm walking up stairs, I do feel like, I have a little bit, more short of breath than I would normally be.",
"speaker": "Patient"
},
{
"start": 392.55828,
"end": 396.78138,
"text": "Sure. Yeah. OK, but you're not short of breath at rest at the moment?",
"speaker": "Doctor"
},
{
"start": 396.57215,
"end": 397.92115,
"text": "No, no, no I'm not.",
"speaker": "Patient"
},
{
"start": 397.83625,
"end": 410.40048,
"text": "OK, fine. So, what, what I think, um, and just to, just to go over, . Is there anything you had hoped about getting other than the uh, a, prescription for your inhalers? Was there anything else you'd hoped about getting from this?",
"speaker": "Doctor"
},
{
"start": 409.95476,
"end": 417.38433,
"text": "Well I just wanna know that I'm OK, to just like keep. I just don't wanna have to get, um, that, that intubation again.",
"speaker": "Patient"
},
{
"start": 417.38548,
"end": 430.62615,
"text": "Sure, yeah, no, absolutely. Well, I'm really glad you have talked to me today. I think what we can do is, is give you a prescription for, uh, some more of the inhalers. We can get that to you, within the hour, I would hope.",
"speaker": "Doctor"
},
{
"start": 418.41789,
"end": 420.68635,
"text": "Uh, .",
"speaker": "Patient"
},
{
"start": 430.62615,
"end": 449.13753,
"text": "Um, and, uh, I think, what, the other thing I'd like to do is just give you a, dose of steroids. So this is, these are tablets which, um, you can take for five days. Uh, two tablets in the morning. And, uh, that should just dampen down your asthmatic response, OK.",
"speaker": "Doctor"
},
{
"start": 448.9281,
"end": 449.53884,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 449.13753,
"end": 468.49854,
"text": "Um, now there are some side effects to the steroids. Which I should really tell you about, but please read the label, that's associated with. Don't be too worried about the side effects. They're , most, you know , most of the time the steroids are, very well tolerated. And, uh, you . Have you had them in the past, do you know of?",
"speaker": "Doctor"
},
{
"start": 468.96847,
"end": 472.23694,
"text": "Sorry, sorry, you were cutting in and out a little bit there. What were you saying?",
"speaker": "Patient"
},
{
"start": 471.28051,
"end": 474.04744,
"text": ". Have you had steroids in the past?",
"speaker": "Doctor"
},
{
"start": 474.71345,
"end": 479.08931,
"text": "Um, I can't remember, probably. I think so.",
"speaker": "Patient"
},
{
"start": 477.60384,
"end": 523.50839,
"text": "Probably, yeah I would too. So, um, they, they can come, they can make you, your mood change, can be slightly low or too, slightly high. Can give you, a high blood sugar, um, and, uh, their. Uh, , they can also cause rash, nausea, um, headaches, but, mostly is well-tolerated, and it should help your asthma an awful lot. Um, uh, what I'd like to do is, is send you these, the, some prescriptions for your, uh, inhalers, , ongoing. So you, um, you can, once you get better from this asthma attack, you can, you can, use the Clenil Modulite in the morning, with Ventolin as a PRN. , so, a Ventolin when you need to, um, when you're getting wheezy.",
"speaker": "Doctor"
},
{
"start": 500.93505,
"end": 501.61291,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 522.56603,
"end": 523.23717,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 523.50839,
"end": 538.29862,
"text": "If you should start to use the Ventolin more than, uh, every three hours. Uh, at, at anytime, it's a good idea to seek medical attention. So, um, see a doctor, um, in some capacity.",
"speaker": "Doctor"
},
{
"start": 536.5124,
"end": 537.00904,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 538.29862,
"end": 549.57417,
"text": "Uh, and, the other thing I'd like to send you is a spacer, which would allow the medication to actually, go into your lungs better. Have you, do you know what a spacer is? Have you used one before?",
"speaker": "Doctor"
},
{
"start": 549.84803,
"end": 555.52591,
"text": "Yeah, yeah, I, somebody told me how to use one a while ago. I don't, I don't really use it, to be honest, but.",
"speaker": "Patient"
},
{
"start": 555.76217,
"end": 557.03285,
"text": "Have you got one?",
"speaker": "Doctor"
},
{
"start": 558.31116,
"end": 560.17693,
"text": "I think I do, I have one somewhere.",
"speaker": "Patient"
},
{
"start": 560.17572,
"end": 574.61189,
"text": "OK. All right. Well, um, I'll send you another one, and it has some instructions about how to use it, but essentially, uh, couple of puffs to prime it, inside, breathing in and out, um, uh, for five or , five or ten breaths.",
"speaker": "Doctor"
},
{
"start": 575.59312,
"end": 576.25083,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 576.24347,
"end": 584.86004,
"text": "Uh, yeah. So. Uh, was there anything else that was on your mind? Or you're concerned about at this stage?",
"speaker": "Doctor"
},
{
"start": 584.82805,
"end": 586.59987,
"text": ", I think you got me covered.",
"speaker": "Patient"
},
{
"start": 587.01795,
"end": 604.13834,
"text": "OK, and, and uh, I might give you some time off work as well. You can self-certify first seven days, but uh, I think I would advise you just to, rest a little bit until you're feeling a bit better, if you're OK with that. All right?",
"speaker": "Doctor"
},
{
"start": 601.59994,
"end": 607.55969,
"text": "OK, . All righty. Well, thank you very much.",
"speaker": "Patient"
},
{
"start": 606.20602,
"end": 622.567,
"text": "OK. No worries. Any deterioration in your symptoms, like worsening shortness of breath. Um, or just generally concerning symptoms, uh, pain in your chest tightness, uh, feeling light-headed. Uh, then, seek further medical attention anytime please. OK?",
"speaker": "Doctor"
},
{
"start": 622.84165,
"end": 623.91547,
"text": "All right, sounds good.",
"speaker": "Patient"
},
{
"start": 624.31889,
"end": 625.86025,
"text": "OK. Thank you.",
"speaker": "Doctor"
},
{
"start": 625.78796,
"end": 626.97588,
"text": "OK, thank you. Bye bye.",
"speaker": "Patient"
},
{
"start": 627.18844,
"end": 627.76254,
"text": "Bye bye.",
"speaker": "Doctor"
}
],
"doctor_utterances": "Ohh hello. Hi, how you doing? Uh, my name's Joe. I'm one of the doctors here at Babylon. Can I just confirm your name please? Yes. Brian . Hi Daniel. And your date of birth? . Ninety two. OK, Daniel. And uh, are you in a, a comfortable and confidential place to talk? , happy to go ahead. Great. How can I help? OK. And how long has this been going on for Daniel? OK. And, so, tight chest, three hours. Um, and, so you're born in ninety two, so that makes you twenty six? Um, and, you are, uh. Any shortness of breath at all, with that? Uh, any cough? Wheeze? Slight cough, yeah. , sore throat? Runny nose? Sore ears? Mm-hmm. Are you feeling better now, other than the tight chest? Right. OK, OK, but you now, now you've got this, this um. So you've still got, still got uh, symptoms of a cold, essentially? Uh, ooh, yeah, OK. And are you coughing up anything? And, um, do you have any other medical problems, like asthma? , OK. You have any, inhalers? Or any, any medications? Yeah. Clenil, Clenil Modulite, yeah, OK. And um, uh, have you been using Clenil and the Ventolin? And how often have you been using them? Both of them? Yeah, sure. OK. All right, all right. So, so, so you've, you haven't got any Clenil, or any Ventolin at the moment? OK. All right. Um, and , any drug allergies, that you know of? OK, great. Now, uh, do you, anyone in your family have any medical problems, that you know of? Hmm. OK. Um. Right. So, just uh, , do you have any other, sort of concerns? Or ideas about what might be going on? Or, um, hopes for this consultation? Yeah, absolutely, I can, I can imagine. Um, well, it certainly sounds like uh, you've, you've had this cold, so you've got wheezy with a cough. Um, and it's non-productive cough, and you're short of breath. Uh, is the cough worse at night-time? Yeah. OK. And you've got this tight, tight chest. But you, you wouldn't say you've got chest pains? It's more of a tight chest, is it? Yeah, sure. Um, OK. Well, I, I would quite like to, uh, certainly get you some, uh, Ventolin, Clenil Modulite. Have you had asthma exacerbations in the past? Yeah. Have you ever been to hospital, uh, as an inpatient? As in, you know, stayed in there overnight, for asthma? Ohh, OK. So you, so, so you, uh, you , you went to hospital, and had a, a, . So you stayed in hospital for a few days did you, with an asthma exacerbation? OK, but currently you're just on Ventolin and Clenil? And you haven't got any of those steroids, uh, those inhalers at the moment? OK. When, sorry, how old were you when you had that severe asthma exacerbation? Sure. OK. Um. Just to quantify how short of breath you are, um, I don't suppose you've got a peak flow with you? No, you won't have will you. Um, are you able to, uh, like walk up, flights of stairs OK? Walk on the flat OK, without getting to short of breath? Or um, are you short of breath at rest? Sure. Yeah. OK, but you're not short of breath at rest at the moment? OK, fine. So, what, what I think, um, and just to, just to go over, . Is there anything you had hoped about getting other than the uh, a, prescription for your inhalers? Was there anything else you'd hoped about getting from this? Sure, yeah, no, absolutely. Well, I'm really glad you have talked to me today. I think what we can do is, is give you a prescription for, uh, some more of the inhalers. We can get that to you, within the hour, I would hope. Um, and, uh, I think, what, the other thing I'd like to do is just give you a, dose of steroids. So this is, these are tablets which, um, you can take for five days. Uh, two tablets in the morning. And, uh, that should just dampen down your asthmatic response, OK. Um, now there are some side effects to the steroids. Which I should really tell you about, but please read the label, that's associated with. Don't be too worried about the side effects. They're , most, you know , most of the time the steroids are, very well tolerated. And, uh, you . Have you had them in the past, do you know of? . Have you had steroids in the past? Probably, yeah I would too. So, um, they, they can come, they can make you, your mood change, can be slightly low or too, slightly high. Can give you, a high blood sugar, um, and, uh, their. Uh, , they can also cause rash, nausea, um, headaches, but, mostly is well-tolerated, and it should help your asthma an awful lot. Um, uh, what I'd like to do is, is send you these, the, some prescriptions for your, uh, inhalers, , ongoing. So you, um, you can, once you get better from this asthma attack, you can, you can, use the Clenil Modulite in the morning, with Ventolin as a PRN. , so, a Ventolin when you need to, um, when you're getting wheezy. If you should start to use the Ventolin more than, uh, every three hours. Uh, at, at anytime, it's a good idea to seek medical attention. So, um, see a doctor, um, in some capacity. Uh, and, the other thing I'd like to send you is a spacer, which would allow the medication to actually, go into your lungs better. Have you, do you know what a spacer is? Have you used one before? Have you got one? OK. All right. Well, um, I'll send you another one, and it has some instructions about how to use it, but essentially, uh, couple of puffs to prime it, inside, breathing in and out, um, uh, for five or , five or ten breaths. Uh, yeah. So. Uh, was there anything else that was on your mind? Or you're concerned about at this stage? OK, and, and uh, I might give you some time off work as well. You can self-certify first seven days, but uh, I think I would advise you just to, rest a little bit until you're feeling a bit better, if you're OK with that. All right? OK. No worries. Any deterioration in your symptoms, like worsening shortness of breath. Um, or just generally concerning symptoms, uh, pain in your chest tightness, uh, feeling light-headed. Uh, then, seek further medical attention anytime please. OK? OK. Thank you. Bye bye.",
"patient_utterances": "Hello. Hi. Yeah, sure. My name's Daniel . Yeah. May . Nineteen ninety two. Yeah. Totally. Um, yeah, I just, my chest has been feeling really tight. Uh, for about. Three hours now. Twenty six, yeah. Yeah, like a little bit, um. Yeah, a little bit short of breath, not too bad. Yeah, I'm feeling a bit wheezy, as well. Kind of cough , coughing, yeah. Yeah. You know I had a cold last week, and, it's not as bad as it was, but yeah, I had a sore throat, I had a runny nose. Uh, just feeling under the weather. I mean I feel worse, but the runny nose isn't as bad any more. . Yeah, but the cough's kind of stuck around. Uh, no. Yeah, yeah, I have asthma, I've had it for a while now, um. And then I have like, a hayfever, you know, and some allergies just to dust, stuff like that. Um, yeah, so, uh, you know the um, uh, Ventolin. It's called uh, Salbutamol. I got that one, and then I have a steroid, a Clenil, Clenil inhaler. Yeah, yeah. Um, well to be honest, I was away at uni last week, and I forgot to bring it with me, so I haven't really in the past week. Uh. Because , because um, sorry, they ran out and I, I forgot to, go and grab the next one. About a week ago. Yeah. Not with me right now, no, I ran out. No, no, not allergic to anything. Just like, just the, dust and stuff, but nothing, no drugs. Um, yeah, my mum has eczema, and my dad has asthma. , ohh, when I was young, I also had eczema. And I had a milk protein allergy, when I was young too. Um. Not really, like I feel like asthma's probably a part of it, and, probably getting my, inhalers would be helpful Um. It's just kinda scary, 'cause I haven't had, a time like this where I've been so, tight, uh, in a long time. I mean, it gets a little bit worse at night but, basically, just pretty consistent, and it hasn't gone away. No, not really pain, it's more like, tight. It just feels like sometimes, I can't get a full breath in, you know. Not in a long time. When I was young, a little bit, more like, back in high school. Um, but, I've been pretty good at taking my , my inhalers, so, not, not so much any more. Yeah, when I was in high school, I had to have a tube put down my throat. Yeah I did, yeah. Yeah, I'm doing pretty good, I'm doing pretty good, just on the Clenil, and the Salbutamol. Uh, I think I was like seventeen. Sixteen maybe. No, no. Uh, I'm definitely not short of breath at rest, like, except for that feeling I was describing. It does when I'm walking up stairs, I do feel like, I have a little bit, more short of breath than I would normally be. No, no, no I'm not. Well I just wanna know that I'm OK, to just like keep. I just don't wanna have to get, um, that, that intubation again. Uh, . OK. Sorry, sorry, you were cutting in and out a little bit there. What were you saying? Um, I can't remember, probably. I think so. OK. OK. Yeah. Yeah, yeah, I, somebody told me how to use one a while ago. I don't, I don't really use it, to be honest, but. I think I do, I have one somewhere. OK. , I think you got me covered. OK, . All righty. Well, thank you very much. All right, sounds good. OK, thank you. Bye bye.",
"num_turns": 102,
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"dialogue": "[Patient] Hello.\n[Doctor] Hello, hi, how you doing?\n[Patient] Hi. Good, thank you. How are you?\n[Doctor] Fine thanks, yeah. I'm Joe, I'm one of the doctors at Babylon. Can i just confirm your name please?\n[Patient] you. Um, my name's Lizzy Irvine. Um. Twenty third of July, nineteen ninety five.\n[Doctor] Great, thank you, Lizzy. Um, and are you, in a, confidential and comfortable space to talk?\n[Patient] Yeah. Especially on a Friday. Comfortable.\n[Doctor] Great. Um, how can I help?\n[Patient] Yeah, just for the last couple of days, um, I've been, feeling, um, really sick in my, lower tummy. Um, and I've had a bit of a temperature, so feeling quite like hot and sweaty. And it's yeah, getting really uncomfortable.\n[Doctor] OK, so you've been feeling, uh nauseous. Um, and you've had some, pain in your lower tummy? Or you say you've been feeling sick in your lower tummy?\n[Patient] Yeah, it's more of an ache. So, like an ache in my lower tummy. And then I, I think feeling hot and sweaty. So think it's sickness, but, yeah, bit of an ache.\n[Doctor] OK.\n[Doctor] OK. So a bit um. Feeling, hot, sweaty, unwell, for three days. Uh, feeling sick, nausea, um, with an ache in your lower tummy. Any actual vomiting?\n[Patient] Um, so yeah, no just nauseous, no vomiting yet, luckily. And it's only been for a couple of days, but yeah.\n[Doctor] Two days yeah. OK. Um, and uh, any problems with your waterworks or diarrhoea?\n[Patient] No, so I'm, I'm going , I'm going to the loo a little bit more often than usual. Um, , I drink lots of water, but it does feel like more often.\n[Doctor] about.\n[Patient] Um.\n[Patient] Yeah, like nothing, nothing too out of the ordinary. Um, and I was, I was a little bit like um, uh, I don't know constipated I guess, uh. About a week ago, but I'm OK now.\n[Doctor] OK. So you've, bit constipated a week ago. Uh , things uh. You're having regular bowel motions now. You said you had a, bit of, diarrhoea, or a bit of watery, did you say?\n[Patient] No, it was more like I was just, a little bit bunged up, and then, about a week ago that kinda cleared, and I'm a, normal now.\n[Doctor] OK. And, you say you're going, you're drinking lots of water. You're going to the toilet more frequently, for a wee, is that?\n[Patient] Yes, yeah I'd say so. I, I tend to drink a lot of water anyway but, I feel like I'm going to the toilet, more.\n[Doctor] Hmm. Any pain when you pass urine?\n[Patient] Um, no, no pain.\n[Doctor] No stinging?\n[Patient] Uh, no. Just , it seems, normal yeah.\n[Doctor] OK, and um, and sort of no foul smelling urine, or anything like that?\n[Patient] Um, no, nothing, nothing I can think of, no.\n[Doctor] You having, you're saying you, you're going a bit more frequently. And are you having to go with urgency, to the toilet, for a wee?\n[Patient] No, there's no urgency. Um, yeah, no pain or urgency. Just, yeah, peeing quite frequently, but it's all seeming normal. Yeah, I probably wouldn't have, thought of, it being, linked but, yeah.\n[Doctor] OK. All right so you're. Um, so the main symptom is feeling sick, uh with this. Uh, and you've been feeling bunged up, and this this sort of, pain in your tummy. Just to ask a few more question about the pain in your tummy. Is it, how would you describe the pain?\n[Patient] Um, it's. Yeah, it's like below my belly button. Um, it's, it's aching. Um, it does make me feel nauseous. Um.\n[Patient] Yeah, so it's kinda more like a, I guess like an, an, a, a dull ache. Um, just below the belly button, kind of, yeah, here.\n[Doctor] Um, and it's, it, is it constant? Or is it coming and going?\n[Patient] Um, it's, yeah it's, feeling pretty constant, over the last couple of day. It.\n[Doctor] Um, and just need to ask a few questions about, uh, your periods and stuff. Uh, any chance you could be pregnant at the moment?\n[Patient] Um. Ooh, I don't know.\n[Doctor] \n[Patient] Um, probably not, I don't think so. I'm very careful.\n[Doctor] sexually active at the moment?\n[Patient] Yes, yeah.\n[Doctor] And, um, .\n[Patient] You mentioned about periods. I did notice a bit of, um. I don't know it's like , not necessarily like spotting, but in like, in my, my pee is like a little, I suppose. I think I thought it was my period, it's like a little bit, pink.\n[Doctor] In your pee, did you say? Your, so your pee is slightly red? Or slightly pink?\n[Patient] But I am kind of like due, on my, didn't know if that was like, yeah, a part of it.\n[Doctor] OK. So, when was your last menstrual period?\n[Patient] Um, around a month ago, yeah, three and a, three and a bit weeks ago.\n[Doctor] Ah, OK. Um, so it's three . And, uh, did you say? So you're sexually active, you're using contraception? And what?\n[Patient] Mm-hmm, yeah. I've got the arm, the implants.\n[Doctor] Um.\n[Doctor] And.\n[Doctor] Uh, , one sexual partner? Um, a regular, regular boyfriend or?\n[Patient] Yeah. Yep.\n[Doctor] Um.\n[Doctor] , to go back to your symptom of, uh, constipation. Can I just clarify, when was the last time you had a bowel motion?\n[Patient] Uh, yesterday.\n[Doctor] OK, and, uh, do you feel like, you, are still quite bunged up at the moment?\n[Patient] Uh, no it seems to have cleared up. So I was, about a week ago, but I'm OK, OK now, the last few days. Yeah, I K.\n[Doctor] OK, all right. So you, just to sort of confirm your symptoms. Um, you're feeling sort of sick, nauseous, with tummy pain, which is fairly constant. Um, how, , did the tummy pain come on suddenly or gradually?\n[Patient] Um, it's only been for the last two days. Um, so I guess yeah, quite recently.\n[Doctor] OK.\n[Doctor] So it's, it's come on gradually, has it?\n[Patient] Yeah.\n[Doctor] Not a sudden onset? OK, and uh, your last menstrual period was just three and a bit weeks ago. Um, and you, but you say you've had some . A little bit of spotting, possibly before um, in-between periods, or recently.\n[Patient] Yeah, and the last kind of week or so, yeah, the last couple of days really. But, because I was due on. Yeah, I, I think. Yeah, just the last couple of days.\n[Doctor] OK, and, but you're expecting your period soon?\n[Patient] Yes, yeah.\n[Doctor] Sure. Um. OK, and just to ask a few questions. Are you, uh, do you have any other medical, uh, problems? Um, that I need to be aware of?\n[Patient] Uh.\n[Doctor] Don't .\n[Patient] I'm um, allergic to Amoxicillin.\n[Doctor] Allergic to Amoxicillin. Um, but no other medical problems, that you?\n[Patient] No, not that I'm aware of.\n[Doctor] Any drug allergies? Ohh, you mentioned Amoxicillin, but anything else?\n[Patient] No, that's it.\n[Doctor] Um, and, do you take any medications at the moment?\n[Patient] Um, no, no medications, but I'm on the implants. I think it's called um, Implanon.\n[Doctor] Implanon, yeah sure. OK. Uh, do you smoke?\n[Patient] Or something.\n[Patient] No.\n[Doctor] OK, and uh, do you live with, uh, alone? With your partner?\n[Patient] With my boyfriend.\n[Doctor] With your boyfriend. And, um, any other medical, uh sorry, any, uh, diseases run in your, run in your family?\n[Patient] Um. Not any that. Spring to mind in my immediate family. Um, my brother is a type one diabetic.\n[Doctor] Sure.\n[Doctor] great so, um, is there anything that you're particularly concerned about with, um, this nausea, and uh, the constipation?\n[Patient] Um, I don't know it just a really, like really horrible ache. Um. And I'm nauseous, hot, sweaty, feeling, I'm not really sure.\n[Doctor] Mmm.\n[Patient] I, yeah, why it's happening, um. the last couple of days, that's probably all that's.\n[Doctor] yeah.\n[Doctor] Any.\n[Patient] Yeah, it's getting uncomfortable.\n[Doctor] Yeah. Anything that you'd hoped, particularly, to get out of having this consultation?\n[Patient] Anything , sorry?\n[Doctor] was there anything that you'd hoped to, get out of having this specific consultation? Other than a diagnosis, and getting better, and, you know, being on the right track to, to, feeling better?\n[Patient] Yeah, I know that's kind of, I just wanna, um, get back .\n[Doctor] Get to normal, yeah.\n[Patient] but a bit more .\n[Doctor] Yeah, sure, sure. OK, um, so, and then finally. I, I didn't ask you, do you have any discharge, or anything like that, from down below?\n[Patient] Uh, no, no, no discharge.\n[Doctor] No discharge. OK. All right. So, um, I , I, I think, uh. This could be a few different things. It could just be simple constipation. Uh, you mentioned that you were bunged up, but you did go yesterday. So it's, um, and your, your bowel habits, that you've been going regularly. Uh, but you did mention that you were bunged up. Um, but there could be a few other things going on. I would quite like to, uh, see you to do some further, to do an examination, and to do some, some tests as well. Um, we need to definitely rule out pregnancy, with you. And possibly, um, do some other examinations or, or further tests. So, would you be happy to actually see a GP face-to-face, um, soon? Today, ideally.\n[Patient] Yes, yeah.\n[Doctor] Yeah?\n[Patient] Sure, I can make time.\n[Doctor] Are you, and you're feeling hot, hot and, sweaty. Have you been feeling, um, light-headed at all? Or like you're going to faint?\n[Patient] \n[Patient] No, no, not like I'm gonna faint.\n[Doctor] OK. Right well, we're just sort of, timing out, running out of time a little bit. But, um, I'd really like to see you, uh, for some more, uh, examination, investigations. If in the meantime um, between now and, and me, sort or a GP seeing you, you feel worse in any way, you get light-headed. Um, you, uh, uh you have, you develop any symptoms which are concerning to you. Um, then I think you should take them quite seriously, and, and see somebody more urgently if possible. Um, OK. Is that, uh, , was there anything else that you wanna talk about right now? I'm glad we got the ball rolling with this, and uh, we can , um, sort of see you again, to take this a little bit further.\n[Patient] Mm-hmm.\n[Doctor] OK.\n[Patient] Yeah, thank you, really appreciate that.\n[Doctor] OK. All right. Thanks for your time.\n[Patient] \n[Doctor] OK.\n[Patient] cheers, bye.\n[Doctor] Thanks, bye.",
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"text": "Yeah, like nothing, nothing too out of the ordinary. Um, and I was, I was a little bit like um, uh, I don't know constipated I guess, uh. About a week ago, but I'm OK now.",
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"text": "Mm-hmm, yeah. I've got the arm, the implants.",
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"text": "And.",
"speaker": "Doctor"
},
{
"start": 365.16392,
"end": 371.62383,
"text": "Uh, , one sexual partner? Um, a regular, regular boyfriend or?",
"speaker": "Doctor"
},
{
"start": 370.69046,
"end": 373.22646,
"text": "Yeah. Yep.",
"speaker": "Patient"
},
{
"start": 377.20379,
"end": 378.20379,
"text": "Um.",
"speaker": "Doctor"
},
{
"start": 382.32863,
"end": 391.66899,
"text": " , to go back to your symptom of, uh, constipation. Can I just clarify, when was the last time you had a bowel motion?",
"speaker": "Doctor"
},
{
"start": 393.12247,
"end": 394.50212,
"text": "Uh, yesterday.",
"speaker": "Patient"
},
{
"start": 396.20173,
"end": 404.1514,
"text": "OK, and, uh, do you feel like, you, are still quite bunged up at the moment?",
"speaker": "Doctor"
},
{
"start": 405.27168,
"end": 414.10535,
"text": "Uh, no it seems to have cleared up. So I was, about a week ago, but I'm OK, OK now, the last few days. Yeah, I K.",
"speaker": "Patient"
},
{
"start": 414.3941,
"end": 429.94721,
"text": "OK, all right. So you, just to sort of confirm your symptoms. Um, you're feeling sort of sick, nauseous, with tummy pain, which is fairly constant. Um, how, , did the tummy pain come on suddenly or gradually?",
"speaker": "Doctor"
},
{
"start": 431.22128,
"end": 438.41208,
"text": "Um, it's only been for the last two days. Um, so I guess yeah, quite recently.",
"speaker": "Patient"
},
{
"start": 434.85467,
"end": 435.56272,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 438.25036,
"end": 440.57828,
"text": "So it's, it's come on gradually, has it?",
"speaker": "Doctor"
},
{
"start": 440.36384,
"end": 441.13281,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 441.55347,
"end": 456.23366,
"text": "Not a sudden onset? OK, and uh, your last menstrual period was just three and a bit weeks ago. Um, and you, but you say you've had some . A little bit of spotting, possibly before um, in-between periods, or recently.",
"speaker": "Doctor"
},
{
"start": 457.07571,
"end": 468.79349,
"text": "Yeah, and the last kind of week or so, yeah, the last couple of days really. But, because I was due on. Yeah, I, I think. Yeah, just the last couple of days.",
"speaker": "Patient"
},
{
"start": 469.27319,
"end": 472.4346,
"text": "OK, and, but you're expecting your period soon?",
"speaker": "Doctor"
},
{
"start": 473.58224,
"end": 474.65508,
"text": "Yes, yeah.",
"speaker": "Patient"
},
{
"start": 475.16123,
"end": 486.68513,
"text": "Sure. Um. OK, and just to ask a few questions. Are you, uh, do you have any other medical, uh, problems? Um, that I need to be aware of?",
"speaker": "Doctor"
},
{
"start": 486.71629,
"end": 487.39505,
"text": "Uh.",
"speaker": "Patient"
},
{
"start": 487.86715,
"end": 488.62175,
"text": "Don't .",
"speaker": "Doctor"
},
{
"start": 488.17334,
"end": 490.47462,
"text": "I'm um, allergic to Amoxicillin.",
"speaker": "Patient"
},
{
"start": 490.64106,
"end": 496.49042,
"text": "Allergic to Amoxicillin. Um, but no other medical problems, that you?",
"speaker": "Doctor"
},
{
"start": 497.23415,
"end": 498.65551,
"text": "No, not that I'm aware of.",
"speaker": "Patient"
},
{
"start": 498.71117,
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"text": "Any drug allergies? Ohh, you mentioned Amoxicillin, but anything else?",
"speaker": "Doctor"
},
{
"start": 503.24933,
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"text": "No, that's it.",
"speaker": "Patient"
},
{
"start": 506.54271,
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"text": "Um, and, do you take any medications at the moment?",
"speaker": "Doctor"
},
{
"start": 512.48891,
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"text": "Um, no, no medications, but I'm on the implants. I think it's called um, Implanon.",
"speaker": "Patient"
},
{
"start": 517.76268,
"end": 522.62194,
"text": "Implanon, yeah sure. OK. Uh, do you smoke?",
"speaker": "Doctor"
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{
"start": 518.76565,
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"text": "Or something.",
"speaker": "Patient"
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"speaker": "Patient"
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{
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"text": "OK, and uh, do you live with, uh, alone? With your partner?",
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"text": "With my boyfriend.",
"speaker": "Patient"
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"text": "With your boyfriend. And, um, any other medical, uh sorry, any, uh, diseases run in your, run in your family?",
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{
"start": 538.65753,
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"text": "Um. Not any that. Spring to mind in my immediate family. Um, my brother is a type one diabetic.",
"speaker": "Patient"
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{
"start": 549.3089,
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"text": "Sure.",
"speaker": "Doctor"
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{
"start": 554.87392,
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"text": " great so, um, is there anything that you're particularly concerned about with, um, this nausea, and uh, the constipation?",
"speaker": "Doctor"
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{
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"text": "Um, I don't know it just a really, like really horrible ache. Um. And I'm nauseous, hot, sweaty, feeling, I'm not really sure.",
"speaker": "Patient"
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{
"start": 578.17302,
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"text": "Mmm.",
"speaker": "Doctor"
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{
"start": 578.83624,
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"text": "I, yeah, why it's happening, um. the last couple of days, that's probably all that's.",
"speaker": "Patient"
},
{
"start": 580.6007,
"end": 582.26049,
"text": " yeah.",
"speaker": "Doctor"
},
{
"start": 585.67486,
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"text": "Any.",
"speaker": "Doctor"
},
{
"start": 585.73601,
"end": 587.7886,
"text": "Yeah, it's getting uncomfortable.",
"speaker": "Patient"
},
{
"start": 587.52159,
"end": 592.795,
"text": "Yeah. Anything that you'd hoped, particularly, to get out of having this consultation?",
"speaker": "Doctor"
},
{
"start": 594.43477,
"end": 596.32991,
"text": "Anything , sorry?",
"speaker": "Patient"
},
{
"start": 595.73997,
"end": 606.93897,
"text": " was there anything that you'd hoped to, get out of having this specific consultation? Other than a diagnosis, and getting better, and, you know, being on the right track to, to, feeling better?",
"speaker": "Doctor"
},
{
"start": 607.60306,
"end": 611.47063,
"text": "Yeah, I know that's kind of, I just wanna, um, get back .",
"speaker": "Patient"
},
{
"start": 610.746,
"end": 613.11166,
"text": "Get to normal, yeah.",
"speaker": "Doctor"
},
{
"start": 612.70481,
"end": 614.06674,
"text": " but a bit more .",
"speaker": "Patient"
},
{
"start": 614.37066,
"end": 622.05698,
"text": "Yeah, sure, sure. OK, um, so, and then finally. I, I didn't ask you, do you have any discharge, or anything like that, from down below?",
"speaker": "Doctor"
},
{
"start": 622.59993,
"end": 625.82486,
"text": "Uh, no, no, no discharge.",
"speaker": "Patient"
},
{
"start": 625.47322,
"end": 673.01134,
"text": "No discharge. OK. All right. So, um, I , I, I think, uh. This could be a few different things. It could just be simple constipation. Uh, you mentioned that you were bunged up, but you did go yesterday. So it's, um, and your, your bowel habits, that you've been going regularly. Uh, but you did mention that you were bunged up. Um, but there could be a few other things going on. I would quite like to, uh, see you to do some further, to do an examination, and to do some, some tests as well. Um, we need to definitely rule out pregnancy, with you. And possibly, um, do some other examinations or, or further tests. So, would you be happy to actually see a GP face-to-face, um, soon? Today, ideally.",
"speaker": "Doctor"
},
{
"start": 671.70751,
"end": 675.34097,
"text": " Yes, yeah.",
"speaker": "Patient"
},
{
"start": 675.65436,
"end": 676.37585,
"text": "Yeah?",
"speaker": "Doctor"
},
{
"start": 675.82261,
"end": 677.16563,
"text": "Sure, I can make time.",
"speaker": "Patient"
},
{
"start": 677.07001,
"end": 686.32077,
"text": "Are you, and you're feeling hot, hot and, sweaty. Have you been feeling, um, light-headed at all? Or like you're going to faint?",
"speaker": "Doctor"
},
{
"start": 677.7628,
"end": 678.38149,
"text": "",
"speaker": "Patient"
},
{
"start": 687.576,
"end": 689.8897,
"text": "No, no, not like I'm gonna faint.",
"speaker": "Patient"
},
{
"start": 689.79145,
"end": 730.35651,
"text": "OK. Right well, we're just sort of, timing out, running out of time a little bit. But, um, I'd really like to see you, uh, for some more, uh, examination, investigations. If in the meantime um, between now and, and me, sort or a GP seeing you, you feel worse in any way, you get light-headed. Um, you, uh, uh you have, you develop any symptoms which are concerning to you. Um, then I think you should take them quite seriously, and, and see somebody more urgently if possible. Um, OK. Is that, uh, , was there anything else that you wanna talk about right now? I'm glad we got the ball rolling with this, and uh, we can , um, sort of see you again, to take this a little bit further.",
"speaker": "Doctor"
},
{
"start": 730.60513,
"end": 731.20183,
"text": "Mm-hmm.",
"speaker": "Patient"
},
{
"start": 730.90691,
"end": 731.93979,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 732.08913,
"end": 734.26424,
"text": "Yeah, thank you, really appreciate that.",
"speaker": "Patient"
},
{
"start": 734.25917,
"end": 737.45061,
"text": "OK. All right. Thanks for your time.",
"speaker": "Doctor"
},
{
"start": 737.60233,
"end": 738.17386,
"text": "",
"speaker": "Patient"
},
{
"start": 738.45061,
"end": 739.81032,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 739.02596,
"end": 741.78243,
"text": " cheers, bye.",
"speaker": "Patient"
},
{
"start": 740.65205,
"end": 742.51536,
"text": "Thanks, bye.",
"speaker": "Doctor"
}
],
"doctor_utterances": "Hello, hi, how you doing? Fine thanks, yeah. I'm Joe, I'm one of the doctors at Babylon. Can i just confirm your name please? Great, thank you, Lizzy. Um, and are you, in a, confidential and comfortable space to talk? Great. Um, how can I help? OK, so you've been feeling, uh nauseous. Um, and you've had some, pain in your lower tummy? Or you say you've been feeling sick in your lower tummy? OK. OK. So a bit um. Feeling, hot, sweaty, unwell, for three days. Uh, feeling sick, nausea, um, with an ache in your lower tummy. Any actual vomiting? Two days yeah. OK. Um, and uh, any problems with your waterworks or diarrhoea? about. OK. So you've, bit constipated a week ago. Uh , things uh. You're having regular bowel motions now. You said you had a, bit of, diarrhoea, or a bit of watery, did you say? OK. And, you say you're going, you're drinking lots of water. You're going to the toilet more frequently, for a wee, is that? Hmm. Any pain when you pass urine? No stinging? OK, and um, and sort of no foul smelling urine, or anything like that? You having, you're saying you, you're going a bit more frequently. And are you having to go with urgency, to the toilet, for a wee? OK. All right so you're. Um, so the main symptom is feeling sick, uh with this. Uh, and you've been feeling bunged up, and this this sort of, pain in your tummy. Just to ask a few more question about the pain in your tummy. Is it, how would you describe the pain? Um, and it's, it, is it constant? Or is it coming and going? Um, and just need to ask a few questions about, uh, your periods and stuff. Uh, any chance you could be pregnant at the moment? sexually active at the moment? And, um, . In your pee, did you say? Your, so your pee is slightly red? Or slightly pink? OK. So, when was your last menstrual period? Ah, OK. Um, so it's three . And, uh, did you say? So you're sexually active, you're using contraception? And what? Um. And. Uh, , one sexual partner? Um, a regular, regular boyfriend or? Um. , to go back to your symptom of, uh, constipation. Can I just clarify, when was the last time you had a bowel motion? OK, and, uh, do you feel like, you, are still quite bunged up at the moment? OK, all right. So you, just to sort of confirm your symptoms. Um, you're feeling sort of sick, nauseous, with tummy pain, which is fairly constant. Um, how, , did the tummy pain come on suddenly or gradually? OK. So it's, it's come on gradually, has it? Not a sudden onset? OK, and uh, your last menstrual period was just three and a bit weeks ago. Um, and you, but you say you've had some . A little bit of spotting, possibly before um, in-between periods, or recently. OK, and, but you're expecting your period soon? Sure. Um. OK, and just to ask a few questions. Are you, uh, do you have any other medical, uh, problems? Um, that I need to be aware of? Don't . Allergic to Amoxicillin. Um, but no other medical problems, that you? Any drug allergies? Ohh, you mentioned Amoxicillin, but anything else? Um, and, do you take any medications at the moment? Implanon, yeah sure. OK. Uh, do you smoke? OK, and uh, do you live with, uh, alone? With your partner? With your boyfriend. And, um, any other medical, uh sorry, any, uh, diseases run in your, run in your family? Sure. great so, um, is there anything that you're particularly concerned about with, um, this nausea, and uh, the constipation? Mmm. yeah. Any. Yeah. Anything that you'd hoped, particularly, to get out of having this consultation? was there anything that you'd hoped to, get out of having this specific consultation? Other than a diagnosis, and getting better, and, you know, being on the right track to, to, feeling better? Get to normal, yeah. Yeah, sure, sure. OK, um, so, and then finally. I, I didn't ask you, do you have any discharge, or anything like that, from down below? No discharge. OK. All right. So, um, I , I, I think, uh. This could be a few different things. It could just be simple constipation. Uh, you mentioned that you were bunged up, but you did go yesterday. So it's, um, and your, your bowel habits, that you've been going regularly. Uh, but you did mention that you were bunged up. Um, but there could be a few other things going on. I would quite like to, uh, see you to do some further, to do an examination, and to do some, some tests as well. Um, we need to definitely rule out pregnancy, with you. And possibly, um, do some other examinations or, or further tests. So, would you be happy to actually see a GP face-to-face, um, soon? Today, ideally. Yeah? Are you, and you're feeling hot, hot and, sweaty. Have you been feeling, um, light-headed at all? Or like you're going to faint? OK. Right well, we're just sort of, timing out, running out of time a little bit. But, um, I'd really like to see you, uh, for some more, uh, examination, investigations. If in the meantime um, between now and, and me, sort or a GP seeing you, you feel worse in any way, you get light-headed. Um, you, uh, uh you have, you develop any symptoms which are concerning to you. Um, then I think you should take them quite seriously, and, and see somebody more urgently if possible. Um, OK. Is that, uh, , was there anything else that you wanna talk about right now? I'm glad we got the ball rolling with this, and uh, we can , um, sort of see you again, to take this a little bit further. OK. OK. All right. Thanks for your time. OK. Thanks, bye.",
"patient_utterances": "Hello. Hi. Good, thank you. How are you? you. Um, my name's Lizzy Irvine. Um. Twenty third of July, nineteen ninety five. Yeah. Especially on a Friday. Comfortable. Yeah, just for the last couple of days, um, I've been, feeling, um, really sick in my, lower tummy. Um, and I've had a bit of a temperature, so feeling quite like hot and sweaty. And it's yeah, getting really uncomfortable. Yeah, it's more of an ache. So, like an ache in my lower tummy. And then I, I think feeling hot and sweaty. So think it's sickness, but, yeah, bit of an ache. Um, so yeah, no just nauseous, no vomiting yet, luckily. And it's only been for a couple of days, but yeah. No, so I'm, I'm going , I'm going to the loo a little bit more often than usual. Um, , I drink lots of water, but it does feel like more often. Um. Yeah, like nothing, nothing too out of the ordinary. Um, and I was, I was a little bit like um, uh, I don't know constipated I guess, uh. About a week ago, but I'm OK now. No, it was more like I was just, a little bit bunged up, and then, about a week ago that kinda cleared, and I'm a, normal now. Yes, yeah I'd say so. I, I tend to drink a lot of water anyway but, I feel like I'm going to the toilet, more. Um, no, no pain. Uh, no. Just , it seems, normal yeah. Um, no, nothing, nothing I can think of, no. No, there's no urgency. Um, yeah, no pain or urgency. Just, yeah, peeing quite frequently, but it's all seeming normal. Yeah, I probably wouldn't have, thought of, it being, linked but, yeah. Um, it's. Yeah, it's like below my belly button. Um, it's, it's aching. Um, it does make me feel nauseous. Um. Yeah, so it's kinda more like a, I guess like an, an, a, a dull ache. Um, just below the belly button, kind of, yeah, here. Um, it's, yeah it's, feeling pretty constant, over the last couple of day. It. Um. Ooh, I don't know. Um, probably not, I don't think so. I'm very careful. Yes, yeah. You mentioned about periods. I did notice a bit of, um. I don't know it's like , not necessarily like spotting, but in like, in my, my pee is like a little, I suppose. I think I thought it was my period, it's like a little bit, pink. But I am kind of like due, on my, didn't know if that was like, yeah, a part of it. Um, around a month ago, yeah, three and a, three and a bit weeks ago. Mm-hmm, yeah. I've got the arm, the implants. Yeah. Yep. Uh, yesterday. Uh, no it seems to have cleared up. So I was, about a week ago, but I'm OK, OK now, the last few days. Yeah, I K. Um, it's only been for the last two days. Um, so I guess yeah, quite recently. Yeah. Yeah, and the last kind of week or so, yeah, the last couple of days really. But, because I was due on. Yeah, I, I think. Yeah, just the last couple of days. Yes, yeah. Uh. I'm um, allergic to Amoxicillin. No, not that I'm aware of. No, that's it. Um, no, no medications, but I'm on the implants. I think it's called um, Implanon. Or something. No. With my boyfriend. Um. Not any that. Spring to mind in my immediate family. Um, my brother is a type one diabetic. Um, I don't know it just a really, like really horrible ache. Um. And I'm nauseous, hot, sweaty, feeling, I'm not really sure. I, yeah, why it's happening, um. the last couple of days, that's probably all that's. Yeah, it's getting uncomfortable. Anything , sorry? Yeah, I know that's kind of, I just wanna, um, get back . but a bit more . Uh, no, no, no discharge. Yes, yeah. Sure, I can make time. No, no, not like I'm gonna faint. Mm-hmm. Yeah, thank you, really appreciate that. cheers, bye.",
"num_turns": 117,
"reference_note": "{\"day\": 4, \"consultation\": 10, \"presenting_complaint\": \"I have really bad diarrhea\", \"note\": \"Name confirmed. \\n\\n2 days \\nFeeling sick \\nNo vomiting \\nAche - Lower tummy. \\nHot and sweaty \\nDrinks lots of water - Polyuria. \\nNo urgency \\nNo dysuria. \\n\\nConstipated 1 weeks. \\n\\nPain described as - Lower abdo, aching\\nConstant. \\n\\nSexually active - Implant. \\n\\nSpotting\\nLMP 3.5 weeks ago. \\n\\nRegulalr boyfriend. \\n\\nPMhx - Amox \\n\\nNil Meds. \\nShx - Non smoker. \\n\\nFhx -Brther Type 1 dm. \\n\\nImp- Simple constipation, PID, STI, UTI \\n\\nPlan - Needs further examination and Ix. \\nPregnancy test, U+E, \\n\", \"highlights\": [\"\"]}",
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"consultation_id": "day5_consultation02",
"dialogue": "[Doctor] Good morning. I'm Doctor Smith from Babylon. Can you just confirm your name, date of birth, and the first line of your address please?\n[Patient] Hi. My name is Susan. Um, thirty, Redbridge Street, SW two two HZ.\n[Doctor] Hello.\n[Doctor] And your date of birth?\n[Patient] forty, oh two, nineteen seventy four.\n[Doctor] OK. Are you in a private place so you can have a consultation today?\n[Patient] Yes I am.\n[Doctor] OK. What can I do for you?\n[Patient] It hurts when I pee.\n[Doctor] OK, and how long has that been going on for?\n[Patient] It stays now.\n[Doctor] Pardon?\n[Patient] Uh, six days.\n[Doctor] Six days, OK. And just tell me a bit more about that. How did it start?\n[Patient] Um, I've got this thing when I pee, and it hurts when I go to the loo, and I've got this very unpleasant smell that comes out.\n[Doctor] \n[Doctor] OK. And, have you had any other symptoms along with that? Have you had any abdominal pain, or back, lower back pain at all?\n[Patient] I've got, pain in my tummy.\n[Doctor] Uh, whereabouts?\n[Patient] In my lower tummy.\n[Doctor] OK. Is it one-sided, or in the middle?\n[Patient] In the middle.\n[Doctor] And how bad would you say that is on a scale of one to ten? With ten being the worst pain.\n[Patient] Seven. Seven.\n[Doctor] And is it, constant, or does it come and go?\n[Patient] Comes and goes.\n[Doctor] OK. And have you actually been able to pass water OK?\n[Patient] Yes, but I've had spotted, uh, blood in my urine. Spots.\n[Doctor] OK. And is that just over the last, six days?\n[Patient] Yes.\n[Doctor] Right. And have you been able to eat and drink OK?\n[Patient] Yes.\n[Doctor] Um, and, have you had a temperature? Do you feel like you've been feverish, or had a temperature with this?\n[Patient] No, not at all.\n[Doctor] Um, and any, did you , you said you didn't have any lower back pain?\n[Patient] No, I've got. Um, and no loin pain as well.\n[Doctor] OK. And, have you had these symptoms before?\n[Patient] No.\n[Doctor] Never.\n[Patient] No.\n[Doctor] And was there anything you were doing recently, which you think may have contributed to it? Have you , have you been doing lots of exercise, been dehydrated, um, been having regular sexual intercourse or anything?\n[Patient] No.\n[Doctor] No, OK. And, any, any other symptoms, any vaginal discharge or, anything like that?\n[Patient] No, just the blood spot, in my.\n[Doctor] No. Do you have regular periods?\n[Patient] Yes I do.\n[Doctor] OK.\n[Doctor] Um, and , in the past, have you had any medical problems at all?\n[Patient] No medical, no.\n[Doctor] Have you had any problems with your kidneys, or any urine infections?\n[Patient] I had IBS before.\n[Doctor] OK. And how's that been recently? Any change in your bowel habit? Any blood when you pass stool?\n[Patient] Yeah, I've had spotting in my urine.\n[Doctor] In your, OK. Um, any change in your bowel habit? Any weight loss or anything?\n[Patient] No.\n[Patient] No.\n[Doctor] Any other medical problems, or surgery in the past?\n[Patient] No.\n[Doctor] Do you take regular medications?\n[Patient] I've had Mebeverine, Mebeverine. I've had Mebeverine.\n[Doctor] Pardon? No birth . Do you take that regularly?\n[Patient] Yes.\n[Doctor] OK. And it, do you take it three times a day?\n[Patient] Yes I do.\n[Doctor] Two hundred milligrams?\n[Patient] Yes.\n[Doctor] Any allergies?\n[Doctor] Any allergies?\n[Patient] Clindamycin.\n[Doctor] You're allergic to Clindamycin, OK. And anyone in your family had any medical problems?\n[Patient] No.\n[Doctor] That's fine. And whereabouts, do you live? Do you live with friends, family?\n[Patient] I live with friends.\n[Doctor] OK. And where do you work? What's your job?\n[Patient] I'm a support worker.\n[Doctor] OK. Do you drink alcohol at all?\n[Patient] Occasionally.\n[Doctor] So how much in a average week?\n[Patient] One glass of wine a week.\n[Doctor] OK. And do you smoke?\n[Patient] No.\n[Doctor] OK. Um, it sounds very much like you, might have an infection in your urine. Did you say, you haven't felt feverish?\n[Patient] No fever at all.\n[Doctor] Have you got a thermometer at home?\n[Patient] No.\n[Doctor] OK. It would be helpful if you could get a thermometer from the pharmacy and, do check your temperature, just to make sure that it isn't, going up and down.\n[Patient] OK.\n[Doctor] Um, normally we can treat this infection without having to test your urine. Uh, with, with a course of antibiotics.\n[Patient] OK.\n[Doctor] Um, how do you feel about that? Are you happy to take a course of antibiotics?\n[Patient] Yes I would be.\n[Doctor] It would just be for three days.\n[Patient] OK.\n[Doctor] Um.\n[Patient] , get my prescription.\n[Doctor] Yes, so I can send a prescription through to your requested pharmacy for that. If you take them, as soon as you can, get them, pick them up as soon as you can, and start taking them. The other thing which is important to do is to drink, lots of water. So, two and a half to three litres a day.\n[Patient] \n[Doctor] Um, you can get some cranberry juice and take, drink that as well, that sometimes helps. And also some, sachets um, which you can get from the chemist, some sachets which just help change the acidity of your urine. So I, I can put the details of that on your notes.\n[Patient] Yeah.\n[Patient] OK then.\n[Doctor] Um, if you feel like your pain is getting worse or not settling, you get lower back pain, um, or you're getting a high temperature, or you have any problems actually passing urine. Then it's very important that we speak to you again.\n[Patient] OK.\n[Doctor] Um, the other thing is that if it becomes a, common, thing or a recurrent problem. Then we need to talk to you again about it.\n[Patient] So, do I have to call after I finish my course of antibiotics.\n[Doctor] No, not if you're better. If you're, if you feel like your symptoms get worse at any point, or they're not resolving with the treatment. Or you keep getting a similar, um, you keep getting a similar, problem, reccurently. Then it's important for us to talk, talk to you in more detail about that.\n[Patient] OK.\n[Patient] Yeah.\n[Patient] OK then.\n[Doctor] Um, have you got any other questions?\n[Patient] Uh, no. Uh, where will be the pharmacy I'll be picking up, my medication from?\n[Doctor] Um, so have you already requested a pharmacy through Babylon?\n[Patient] Yes I did.\n[Doctor] Can I just check that with you?\n[Patient] Knightsbridge, Practice.\n[Doctor] OK, that's fine. So the antibiotics, that I'm gonna prescribe, um, will go through to that, pharmacy.\n[Patient] How soon?\n[Doctor] And then , you'll be able to pick them up from there.\n[Patient] How soon is that gonna be, at the practice? In five minutes?\n[Doctor] Um, I would give it longer than that. Give it a, an hour or so.\n[Patient] All right then. Thank you, I'll pick that at lunchtime.\n[Doctor] OK. All right then. Take care. Bye.\n[Patient] Thank you. . Bye.\n[Doctor] Sorry, I .",
"turns": [
{
"start": 1.58752,
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"text": "Good morning. I'm Doctor Smith from Babylon. Can you just confirm your name, date of birth, and the first line of your address please?",
"speaker": "Doctor"
},
{
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"text": "Hi. My name is Susan. Um, thirty, Redbridge Street, SW two two HZ.",
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{
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"text": "Hello.",
"speaker": "Doctor"
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{
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"text": "And your date of birth?",
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"text": "forty, oh two, nineteen seventy four.",
"speaker": "Patient"
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"text": "OK. Are you in a private place so you can have a consultation today?",
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"text": "Yes I am.",
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"text": "OK. What can I do for you?",
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{
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"text": "It hurts when I pee.",
"speaker": "Patient"
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{
"start": 35.59068,
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"text": "OK, and how long has that been going on for?",
"speaker": "Doctor"
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"text": "It stays now.",
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"start": 40.24708,
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"text": "Pardon?",
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{
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"text": "Uh, six days.",
"speaker": "Patient"
},
{
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"text": "Six days, OK. And just tell me a bit more about that. How did it start?",
"speaker": "Doctor"
},
{
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"text": "Um, I've got this thing when I pee, and it hurts when I go to the loo, and I've got this very unpleasant smell that comes out.",
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{
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"text": "I've got, pain in my tummy.",
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"text": "Uh, whereabouts?",
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{
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"text": "OK. And is that just over the last, six days?",
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"text": "And was there anything you were doing recently, which you think may have contributed to it? Have you , have you been doing lots of exercise, been dehydrated, um, been having regular sexual intercourse or anything?",
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"text": "No.",
"speaker": "Patient"
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{
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"text": "No, OK. And, any, any other symptoms, any vaginal discharge or, anything like that?",
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{
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"text": "No, just the blood spot, in my.",
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{
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"speaker": "Doctor"
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{
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"text": "Um, and , in the past, have you had any medical problems at all?",
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"text": "No medical, no.",
"speaker": "Patient"
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{
"start": 172.82501,
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"text": "Have you had any problems with your kidneys, or any urine infections?",
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{
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{
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"text": "Yeah, I've had spotting in my urine.",
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{
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"text": "In your, OK. Um, any change in your bowel habit? Any weight loss or anything?",
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"speaker": "Patient"
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"speaker": "Patient"
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"text": "Any other medical problems, or surgery in the past?",
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"speaker": "Patient"
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{
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"text": "Do you take regular medications?",
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{
"start": 204.73801,
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"text": "I've had Mebeverine, Mebeverine. I've had Mebeverine.",
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{
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"text": "Pardon? No birth . Do you take that regularly?",
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{
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"text": "Yes.",
"speaker": "Patient"
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{
"start": 212.39608,
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"text": "OK. And it, do you take it three times a day?",
"speaker": "Doctor"
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{
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"text": "Yes I do.",
"speaker": "Patient"
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{
"start": 216.76529,
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"text": "Two hundred milligrams?",
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{
"start": 218.68544,
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"text": "Yes.",
"speaker": "Patient"
},
{
"start": 220.43179,
"end": 221.76529,
"text": "Any allergies?",
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{
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"text": "Any allergies?",
"speaker": "Doctor"
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{
"start": 228.48249,
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"text": "Clindamycin.",
"speaker": "Patient"
},
{
"start": 230.04114,
"end": 236.7101,
"text": "You're allergic to Clindamycin, OK. And anyone in your family had any medical problems?",
"speaker": "Doctor"
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{
"start": 237.03142,
"end": 237.88104,
"text": "No.",
"speaker": "Patient"
},
{
"start": 238.83809,
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"text": "That's fine. And whereabouts, do you live? Do you live with friends, family?",
"speaker": "Doctor"
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{
"start": 243.98635,
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"text": "I live with friends.",
"speaker": "Patient"
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{
"start": 245.30269,
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"text": "OK. And where do you work? What's your job?",
"speaker": "Doctor"
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{
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"text": "I'm a support worker.",
"speaker": "Patient"
},
{
"start": 254.75146,
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"text": "OK. Do you drink alcohol at all?",
"speaker": "Doctor"
},
{
"start": 257.86613,
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"text": "Occasionally.",
"speaker": "Patient"
},
{
"start": 259.33766,
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"text": "So how much in a average week?",
"speaker": "Doctor"
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{
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"text": "One glass of wine a week.",
"speaker": "Patient"
},
{
"start": 263.52961,
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"text": "OK. And do you smoke?",
"speaker": "Doctor"
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{
"start": 265.35488,
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"text": "No.",
"speaker": "Patient"
},
{
"start": 267.33076,
"end": 276.13764,
"text": "OK. Um, it sounds very much like you, might have an infection in your urine. Did you say, you haven't felt feverish?",
"speaker": "Doctor"
},
{
"start": 276.18953,
"end": 277.72337,
"text": "No fever at all.",
"speaker": "Patient"
},
{
"start": 277.39281,
"end": 279.53074,
"text": "Have you got a thermometer at home?",
"speaker": "Doctor"
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"start": 280.33993,
"end": 281.33993,
"text": "No.",
"speaker": "Patient"
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{
"start": 281.24798,
"end": 290.94899,
"text": "OK. It would be helpful if you could get a thermometer from the pharmacy and, do check your temperature, just to make sure that it isn't, going up and down.",
"speaker": "Doctor"
},
{
"start": 290.72345,
"end": 291.62571,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 290.94899,
"end": 298.64599,
"text": "Um, normally we can treat this infection without having to test your urine. Uh, with, with a course of antibiotics.",
"speaker": "Doctor"
},
{
"start": 299.18967,
"end": 300.49795,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 300.33079,
"end": 304.5583,
"text": "Um, how do you feel about that? Are you happy to take a course of antibiotics?",
"speaker": "Doctor"
},
{
"start": 304.53556,
"end": 305.97918,
"text": "Yes I would be.",
"speaker": "Patient"
},
{
"start": 305.74204,
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"text": "It would just be for three days.",
"speaker": "Doctor"
},
{
"start": 308.29498,
"end": 309.18219,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 309.79278,
"end": 310.79278,
"text": "Um.",
"speaker": "Doctor"
},
{
"start": 310.11243,
"end": 312.15965,
"text": ", get my prescription.",
"speaker": "Patient"
},
{
"start": 312.26174,
"end": 330.14447,
"text": "Yes, so I can send a prescription through to your requested pharmacy for that. If you take them, as soon as you can, get them, pick them up as soon as you can, and start taking them. The other thing which is important to do is to drink, lots of water. So, two and a half to three litres a day.",
"speaker": "Doctor"
},
{
"start": 327.86653,
"end": 328.54322,
"text": "",
"speaker": "Patient"
},
{
"start": 330.14447,
"end": 346.79962,
"text": "Um, you can get some cranberry juice and take, drink that as well, that sometimes helps. And also some, sachets um, which you can get from the chemist, some sachets which just help change the acidity of your urine. So I, I can put the details of that on your notes.",
"speaker": "Doctor"
},
{
"start": 330.14473,
"end": 330.79134,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 346.83658,
"end": 347.91177,
"text": "OK then.",
"speaker": "Patient"
},
{
"start": 347.83049,
"end": 363.5588,
"text": "Um, if you feel like your pain is getting worse or not settling, you get lower back pain, um, or you're getting a high temperature, or you have any problems actually passing urine. Then it's very important that we speak to you again.",
"speaker": "Doctor"
},
{
"start": 363.72392,
"end": 364.72392,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 364.6028,
"end": 371.33752,
"text": "Um, the other thing is that if it becomes a, common, thing or a recurrent problem. Then we need to talk to you again about it.",
"speaker": "Doctor"
},
{
"start": 371.97961,
"end": 375.53602,
"text": "So, do I have to call after I finish my course of antibiotics.",
"speaker": "Patient"
},
{
"start": 374.88924,
"end": 395.83404,
"text": "No, not if you're better. If you're, if you feel like your symptoms get worse at any point, or they're not resolving with the treatment. Or you keep getting a similar, um, you keep getting a similar, problem, reccurently. Then it's important for us to talk, talk to you in more detail about that.",
"speaker": "Doctor"
},
{
"start": 376.70143,
"end": 377.61873,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 390.17521,
"end": 390.91957,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 396.06998,
"end": 397.06998,
"text": "OK then.",
"speaker": "Patient"
},
{
"start": 397.41335,
"end": 400.07542,
"text": "Um, have you got any other questions?",
"speaker": "Doctor"
},
{
"start": 400.84444,
"end": 405.85199,
"text": "Uh, no. Uh, where will be the pharmacy I'll be picking up, my medication from?",
"speaker": "Patient"
},
{
"start": 405.62713,
"end": 409.2892,
"text": "Um, so have you already requested a pharmacy through Babylon?",
"speaker": "Doctor"
},
{
"start": 409.50614,
"end": 410.65652,
"text": "Yes I did.",
"speaker": "Patient"
},
{
"start": 410.77196,
"end": 412.58575,
"text": "Can I just check that with you?",
"speaker": "Doctor"
},
{
"start": 413.71669,
"end": 415.96482,
"text": "Knightsbridge, Practice.",
"speaker": "Patient"
},
{
"start": 416.40643,
"end": 424.4478,
"text": "OK, that's fine. So the antibiotics, that I'm gonna prescribe, um, will go through to that, pharmacy.",
"speaker": "Doctor"
},
{
"start": 425.35586,
"end": 426.35586,
"text": "How soon?",
"speaker": "Patient"
},
{
"start": 425.4478,
"end": 428.43401,
"text": "And then , you'll be able to pick them up from there.",
"speaker": "Doctor"
},
{
"start": 428.69422,
"end": 432.02507,
"text": "How soon is that gonna be, at the practice? In five minutes?",
"speaker": "Patient"
},
{
"start": 432.50297,
"end": 436.58572,
"text": "Um, I would give it longer than that. Give it a, an hour or so.",
"speaker": "Doctor"
},
{
"start": 434.81456,
"end": 439.24314,
"text": " All right then. Thank you, I'll pick that at lunchtime.",
"speaker": "Patient"
},
{
"start": 439.13744,
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"text": "OK. All right then. Take care. Bye.",
"speaker": "Doctor"
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"start": 440.94991,
"end": 444.13788,
"text": "Thank you. . Bye.",
"speaker": "Patient"
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"start": 444.82709,
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"doctor_utterances": "Good morning. I'm Doctor Smith from Babylon. Can you just confirm your name, date of birth, and the first line of your address please? Hello. And your date of birth? OK. Are you in a private place so you can have a consultation today? OK. What can I do for you? OK, and how long has that been going on for? Pardon? Six days, OK. And just tell me a bit more about that. How did it start? OK. And, have you had any other symptoms along with that? Have you had any abdominal pain, or back, lower back pain at all? Uh, whereabouts? OK. Is it one-sided, or in the middle? And how bad would you say that is on a scale of one to ten? With ten being the worst pain. And is it, constant, or does it come and go? OK. And have you actually been able to pass water OK? OK. And is that just over the last, six days? Right. And have you been able to eat and drink OK? Um, and, have you had a temperature? Do you feel like you've been feverish, or had a temperature with this? Um, and any, did you , you said you didn't have any lower back pain? OK. And, have you had these symptoms before? Never. And was there anything you were doing recently, which you think may have contributed to it? Have you , have you been doing lots of exercise, been dehydrated, um, been having regular sexual intercourse or anything? No, OK. And, any, any other symptoms, any vaginal discharge or, anything like that? No. Do you have regular periods? OK. Um, and , in the past, have you had any medical problems at all? Have you had any problems with your kidneys, or any urine infections? OK. And how's that been recently? Any change in your bowel habit? Any blood when you pass stool? In your, OK. Um, any change in your bowel habit? Any weight loss or anything? Any other medical problems, or surgery in the past? Do you take regular medications? Pardon? No birth . Do you take that regularly? OK. And it, do you take it three times a day? Two hundred milligrams? Any allergies? Any allergies? You're allergic to Clindamycin, OK. And anyone in your family had any medical problems? That's fine. And whereabouts, do you live? Do you live with friends, family? OK. And where do you work? What's your job? OK. Do you drink alcohol at all? So how much in a average week? OK. And do you smoke? OK. Um, it sounds very much like you, might have an infection in your urine. Did you say, you haven't felt feverish? Have you got a thermometer at home? OK. It would be helpful if you could get a thermometer from the pharmacy and, do check your temperature, just to make sure that it isn't, going up and down. Um, normally we can treat this infection without having to test your urine. Uh, with, with a course of antibiotics. Um, how do you feel about that? Are you happy to take a course of antibiotics? It would just be for three days. Um. Yes, so I can send a prescription through to your requested pharmacy for that. If you take them, as soon as you can, get them, pick them up as soon as you can, and start taking them. The other thing which is important to do is to drink, lots of water. So, two and a half to three litres a day. Um, you can get some cranberry juice and take, drink that as well, that sometimes helps. And also some, sachets um, which you can get from the chemist, some sachets which just help change the acidity of your urine. So I, I can put the details of that on your notes. Um, if you feel like your pain is getting worse or not settling, you get lower back pain, um, or you're getting a high temperature, or you have any problems actually passing urine. Then it's very important that we speak to you again. Um, the other thing is that if it becomes a, common, thing or a recurrent problem. Then we need to talk to you again about it. No, not if you're better. If you're, if you feel like your symptoms get worse at any point, or they're not resolving with the treatment. Or you keep getting a similar, um, you keep getting a similar, problem, reccurently. Then it's important for us to talk, talk to you in more detail about that. Um, have you got any other questions? Um, so have you already requested a pharmacy through Babylon? Can I just check that with you? OK, that's fine. So the antibiotics, that I'm gonna prescribe, um, will go through to that, pharmacy. And then , you'll be able to pick them up from there. Um, I would give it longer than that. Give it a, an hour or so. OK. All right then. Take care. Bye. Sorry, I .",
"patient_utterances": "Hi. My name is Susan. Um, thirty, Redbridge Street, SW two two HZ. forty, oh two, nineteen seventy four. Yes I am. It hurts when I pee. It stays now. Uh, six days. Um, I've got this thing when I pee, and it hurts when I go to the loo, and I've got this very unpleasant smell that comes out. I've got, pain in my tummy. In my lower tummy. In the middle. Seven. Seven. Comes and goes. Yes, but I've had spotted, uh, blood in my urine. Spots. Yes. Yes. No, not at all. No, I've got. Um, and no loin pain as well. No. No. No. No, just the blood spot, in my. Yes I do. No medical, no. I had IBS before. Yeah, I've had spotting in my urine. No. No. No. I've had Mebeverine, Mebeverine. I've had Mebeverine. Yes. Yes I do. Yes. Clindamycin. No. I live with friends. I'm a support worker. Occasionally. One glass of wine a week. No. No fever at all. No. OK. OK. Yes I would be. OK. , get my prescription. Yeah. OK then. OK. So, do I have to call after I finish my course of antibiotics. OK. Yeah. OK then. Uh, no. Uh, where will be the pharmacy I'll be picking up, my medication from? Yes I did. Knightsbridge, Practice. How soon? How soon is that gonna be, at the practice? In five minutes? All right then. Thank you, I'll pick that at lunchtime. Thank you. . Bye.",
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"reference_note": "{\"day\": 5, \"consultation\": 2, \"presenting_complaint\": \"It hurts when I pee\", \"note\": \"PC: Dysuria\\nHPC: 6/7 hx dysuria, burning stinging sensation when PUs. No problem with actually passing urine. Strong odour. E&D normally. No new PV discharge. No back/loin pain. Not feverish but not checked temp.No obvious trigger, no hx dehydration/frequent SI. \\nNo PHx urine infections/similar sx. \\nNo recent change in BH/blood in stool.\\nPMH: IBS\\nFH: Nil\\nDH: Mebeverine 200mg TDS. NKDA.\\n\\nSH: Lives with friends. Works as support worker. Non smoker. Drinks 1 unit/week.\\nImp: Likely UTI.\\nPlan: Nitrofurantoin 3/7 course. \\nAdvised patient to contact us if fever/back pain/persistent symptoms or if recurrent episodes of similar symptoms occurs. \\n\", \"highlights\": [\"dysuria\", \"Strong odour\", \"No back/loin pain\", \"Not feverish\"]}",
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"dialogue": "[Doctor] Hi there. I'm Doctor Smith from Babylon.\n[Patient] Hi.\n[Doctor] Hi there. Can you just confirm your name, date of birth, and the first line of your address, first of all please?\n[Patient] Yeah. Uh, my name is Valerie Cole. My date of birth is the nineteenth of September, nineteen ninety three.\n[Doctor] My name's .\n[Patient] My address is, uh, sixty four, Cliveden Place, in, South Wimbledon.\n[Doctor] OK. Are you in a private place where you can have a confidential consultation today?\n[Patient] Yes I am, yeah.\n[Doctor] What can I do for you?\n[Patient] Um, I've been feeling really anxious over the past few months. Um, I just get really nervous every morning about leaving the house, and it's started to really worry me, and just add up, and build up on that anxiety. And I just didn't know, who to talk to or, so I wanted to check with my GP.\n[Doctor] OK. Do you mind just telling me a bit more about, when it started? Do you think there's something which changed in your life at that time?\n[Patient] Um, I guess so, I think um, I would say maybe about two months or so, I've been feeling like this, and that probably coincides with, me starting a new job, um. Which I , I would say it's quite , I mean every job is stressful, and when you first start, but it's been really stressful I think over the past two months, definitely.\n[Doctor] What's your job?\n[Patient] Um, so I work for a, a, a fashion retailer, in um, the head office team, and it's just a brand new sector. I've never worked in retail before, my boss is not very nice to me and I don't. But I also think that, it's just been, I just really dread, going there. I just hate, speaking to her, I hate like seeing everyone and, really worried about whether I'm doing well or not. And it's really impacting on like, on the rest of my life, like my sleep and stuff like that.\n[Doctor] OK. So, um, just day-to-day, tell me, from the start of your day, how it affects you. You said that you, you dread going to work. How, how does it affect you, in terms of like your sleep at night, and things like that?\n[Patient] Right.\n[Patient] Yeah, this is really so, I, I, I've, as I say like, I don't want to go to work in the morning, so I just find no way of, I can't get out of bed. But it's also because, when I leave I just, when I've left work, I just feel so stressed and so worried about everything I've done, I can't get to sleep for hours and hours and hours. So I.\n[Doctor] OK. So what time, what time do you go to bed at night-time?\n[Patient] About ten, eleven, probably.\n[Doctor] And what time do you get to sleep?\n[Patient] Not for ages, I'm, I'm lying awake all night\n[Doctor] OK. And, when you eventually get to sleep, do you wake up with your alarm in the morning, or does something else wake you up, before then?\n[Patient] Mmm.\n[Patient] So I find my, my heart kind of racing, and then I'm just like panicking that I'm gonna be late, and that that's gonna make work even more stressful. So I do have an alarm, but I find myself waking up before that, 'cause I'm just my heart is racing. And actually the other day, I was just like, I was lying in bed and I really thought my heart was racing so much, I thought I was gonna have a heart attack in the morning.\n[Doctor] OK. And, so how many hours sleep do you think you get a night?\n[Patient] , I just, I can't even tell because I feel like I'm, even when I'm in sleep it's such a shallow sleep, but maybe, three, four hours, I'm getting now.\n[Doctor] OK. And, what about your eating patterns, any change in how you're eating, or whether you, your appetite's changed?\n[Patient] Probably, not, significant changes maybe. No I wouldn't say that, I wouldn't say that I'm eating like, much differently. Ohh that, I probably have more chocolate than normal, just because I feel, so down.\n[Doctor] OK. You're eating regularly otherwise?\n[Patient] Yeah, .\n[Doctor] OK. And, you told me about the palpitations, just tell me a bit more about that.\n[Patient] Yeah, So um, it's, it's usually kind of like, when I realise in the morning that, either um, I feel like I'm gonna be late, because I've like overslept 'cause I'm so tired. Um, or I wake up in a panic thinking I am gonna be late so, it's just kind of like, just a constant like, rapid heart beating. It's just really, really stressful. I don't know if it's, stress or if, , or I did think it was like, a heart problem really actually.\n[Doctor] \n[Doctor] Does it feel like a regular fast beat, or an irregular, beat?\n[Patient] Irregular, I think.\n[Doctor] And how long do you think it lasts for when you get it?\n[Patient] Ohh it can be anything, I think couple of minutes, or the other day I was actually just, sort of lying there for like, holding my hand on my chest for like ten minutes.\n[Doctor] OK. Is that something that you've had before this, or is that a new thing?\n[Patient] Yeah, but I would say this is only in the past. Sort of like, couple of months as I say that I've been, experiencing this.\n[Doctor] OK. Any chest pain with that?\n[Patient] No, um, well yeah it's painful to , when the heart, when my heart is beating fast but, but, yeah.\n[Doctor] OK.\n[Doctor] And, in the daytime, how, how, you said you, you're not getting much sleep so, how's your energy level in the daytime?\n[Patient] It's just, really, really low, I mean I, I'm finding now that I'm just, I find no enjoyment at all. It's kind of day-to-day, and anything that I'm doing. It's not just my job it's, you know when I leave I'm just so tired that, anything that, previously was, really fun is just not, it's not enjoyable. And I'm like, yeah, on edge the whole time.\n[Doctor] OK. So what do you do in the evenings?\n[Patient] Well right now I'm, I'm working so late, and everything is really, really stressful. So I don't really get much time to myself but, when I do wanna go out, or, you know, see friends or just relax. It, it seems quite difficult to do that.\n[Doctor] OK, and , are you avoiding contact with friends, or do you still see them?\n[Patient] I avoid them insomuch that I, feel like I'm. Yeah, so I mean sometimes it just, I know that I'm not gonna have fun, because I don't want to, go out and, do things that I would normally have done.\n[Doctor] OK. What about, hobbies, or exercise, or anything else outside work? Do you do anything else outside work?\n[Patient] Yeah, as I say like everything that I had previously been doing has been, just difficult to continue with like, I did used to like to like go running, and. And to play tennis and stuff, but now it's just not, I'm just not enjoying it, I'm not, I'm not like, I'm not going out to do that quite so much.\n[Doctor] And have you, has it ever got so bad that you've actually had to miss work?\n[Patient] No, 'cause I think that would just add to the tension, but I do like pretty much every morning I think, ohh I should call in sick or like, just not go.\n[Doctor] OK.\n[Doctor] And, what's the worst that it's got? Have you ever, been, um, so overwhelmed that you couldn't, get in to the office, you couldn't, go into a situation? Have you ever had a panic attack?\n[Patient] , um.\n[Patient] No I wouldn't say so, I think, I've always managed to make it to work. But I, I wonder if it's building up. So this is why I wanted to call, I'm just worried it's building up to that, and I don't know what to do 'cause I have, feel it, felt it, get worse and worse over the past couple of months.\n[Doctor] OK. And apart from work, are there any other situations which evoke quite extreme anxiety, like being, in public places, social situations, public transport, anything like that?\n[Patient] Yeah I mean, I find public transport really stressful anyway, especially being on the tube it's, 'cause it's quite, getting warmer so it's just really airless. Um, but I think the majority of it, 'cause my life is just so focused around work right now, the majority of it is focused around work as well.\n[Doctor] OK. Before this did you have any similar times in your life when you felt like this?\n[Patient] Not really I, I'm, no, I would say. I mean everybody always has a bit of tension, a bit of anxiety but, I've never felt, anything this bad before.\n[Doctor] OK. And what about your mood day-to-day? I mean, I can see that you're quite distressed by like that. Do you ever get really down about this?\n[Patient] Yeah.\n[Patient] Um, I mean, yeah, yeah, 'cause I do, yeah. I'm pretty much, down like, I don't enjoy, being and not just my day at all 'cause. I'm just so worried about everything, um, and I find that even when I'm not, like even at the weekends and stuff it's just the, kind of like constant, feeling of just being a bit, down, a bit unhappy.\n[Doctor] When do you think you last felt yourself?\n[Patient] Um.\n[Patient] I don't know, that's a good question, I can't really, I can't really put a on that at all.\n[Doctor] . And has your mood ever been so low that you've felt like you just couldn't carry on with your job, or with your life, or with your normal, uh, things as they we're going on?\n[Patient] I wouldn't, no I wouldn't say that I've had, I haven't had any suicidal thoughts or any, thoughts that have been that extreme like, I haven't. You know I have, I have a good support system, like I do have good family and stuff. So I, I have, I don't have, uh worries about, actually wanting to, um, not go on. It's just that, I don't wanna go on like this.\n[Doctor] Yeah. OK. And where do you, who do you live with at home?\n[Patient] Sorry?\n[Doctor] Who do you live with at home?\n[Patient] Yeah, I live with my parents, just my parents.\n[Doctor] Um, and, how much alcohol do you have in an average week do you think?\n[Patient] Um, ooh I don't know, probably quite a lot on the Friday or Saturday, just because, that, that's kind of normal, um. Uh, maybe I, maybe I do have like a bit during the week. Like, my parents obviously are retired, so they just drink whenever they want, so, whenever they're having a glass of wine, they'll offer it to me and it's like. I guess I don't really keep track of it that much.\n[Doctor] OK. So, how much would you, would you guess?\n[Patient] Probably like, probably quite a lot on a Friday or Saturday, because it's usually going out, so maybe like. I probably go over my limit just on those days, anyway, and then like, maybe a glass of wine during the week .\n[Doctor] OK. Do you smoke or take any other drugs, or anything?\n[Patient] Um, I try not to smoke, but I do, occasionally, but I don't take drugs.\n[Doctor] OK. And have you done , anything yourself to help? Have you , have you talked to anyone, talked to any counsellors? Done any, online, looked online at all? Any ways to ?\n[Patient] I, well I talk to my mum, because she also suffers from, well she's , suffered from like depression in the past. I didn't think that it was, that I was suffering from, actual depression because it just seems to be, manifesting as, as total , as just stress the whole time.\n[Doctor] OK.\n[Patient] But um, I did talk to my mum about it but I haven't sought any, she recommended that I come to the GP, um, but I haven't sought any other.\n[Doctor] OK.\n[Doctor] And would you be happy to, have, some one-to-one therapy?\n[Patient] \n[Patient] Yeah I think, yeah I think so. I've never done that before, but yeah.\n[Doctor] OK. I mean what we would suggest in the first instance is to, to. So you can self-refer via the NHS, for what we call like, talking therapy which is a type of inter-behavioural, where they can really look at your situation. How you're reacting to, the, , why, what's provoking anxiety, and what you can do, to try and overcome that.\n[Patient] OK.\n[Patient] Yeah.\n[Doctor] Um, so I can send you the link for that. Um, in the meantimes it can be a bit of a wait. There are some online resources that are really helpful. Um, can put the details, on there and you can, get on with them straight away and try and work through them as well.\n[Patient] Uh-huh.\n[Doctor] Um, and if you're feeling like it's not helping at all, or your anxiety is getting worse, to the point where you can't cope with work, or you can't, just do your normal things day-to-day. Then, it's important for us to, for you to give us a call, back and just discuss that, further.\n[Patient] OK. .\n[Doctor] I mean some people, with anxiety they, do need to take medication to control that but that's, not something that we'd suggest in the first instance.\n[Patient] OK.\n[Doctor] And I'll put some more information on your notes about, helping with your, sleep patterns and things like that.\n[Patient] That's great, I look forward to reading it.\n[Doctor] Um, in terms of palpitations, it is most likely to be a, , associated with anxiety, but it's probably worth having couple of basic blood tests just to make sure that, there's not something triggering that off. And then arranging a GP follow-up a week after you've had the tests, so we can just go through the results with you.\n[Patient] \n[Patient] OK, OK. Yeah, .\n[Doctor] So if you call the support line you can arrange the, to have the blood test done.\n[Patient] OK, I'll call them up.\n[Doctor] OK?\n[Patient] Thank you so much.\n[Doctor] All right. Take care.\n[Patient] Have a good day. Bye.\n[Doctor] Sorry. .",
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"start": 238.1884,
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"text": "Yeah, So um, it's, it's usually kind of like, when I realise in the morning that, either um, I feel like I'm gonna be late, because I've like overslept 'cause I'm so tired. Um, or I wake up in a panic thinking I am gonna be late so, it's just kind of like, just a constant like, rapid heart beating. It's just really, really stressful. I don't know if it's, stress or if, , or I did think it was like, a heart problem really actually.",
"speaker": "Patient"
},
{
"start": 258.4974,
"end": 259.12013,
"text": "",
"speaker": "Doctor"
},
{
"start": 264.31588,
"end": 268.47423,
"text": "Does it feel like a regular fast beat, or an irregular, beat?",
"speaker": "Doctor"
},
{
"start": 269.47417,
"end": 271.30124,
"text": "Irregular, I think.",
"speaker": "Patient"
},
{
"start": 271.47913,
"end": 274.04627,
"text": "And how long do you think it lasts for when you get it?",
"speaker": "Doctor"
},
{
"start": 275.6396,
"end": 284.30127,
"text": "Ohh it can be anything, I think couple of minutes, or the other day I was actually just, sort of lying there for like, holding my hand on my chest for like ten minutes.",
"speaker": "Patient"
},
{
"start": 284.53542,
"end": 289.2101,
"text": "OK. Is that something that you've had before this, or is that a new thing?",
"speaker": "Doctor"
},
{
"start": 290.39642,
"end": 296.587,
"text": "Yeah, but I would say this is only in the past. Sort of like, couple of months as I say that I've been, experiencing this.",
"speaker": "Patient"
},
{
"start": 296.38556,
"end": 298.486,
"text": "OK. Any chest pain with that?",
"speaker": "Doctor"
},
{
"start": 299.13241,
"end": 305.94792,
"text": "No, um, well yeah it's painful to , when the heart, when my heart is beating fast but, but, yeah.",
"speaker": "Patient"
},
{
"start": 303.89184,
"end": 304.59277,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 306.22401,
"end": 314.32663,
"text": "And, in the daytime, how, how, you said you, you're not getting much sleep so, how's your energy level in the daytime?",
"speaker": "Doctor"
},
{
"start": 314.70734,
"end": 335.72993,
"text": "It's just, really, really low, I mean I, I'm finding now that I'm just, I find no enjoyment at all. It's kind of day-to-day, and anything that I'm doing. It's not just my job it's, you know when I leave I'm just so tired that, anything that, previously was, really fun is just not, it's not enjoyable. And I'm like, yeah, on edge the whole time.",
"speaker": "Patient"
},
{
"start": 335.30915,
"end": 337.57082,
"text": "OK. So what do you do in the evenings?",
"speaker": "Doctor"
},
{
"start": 338.27756,
"end": 351.76756,
"text": "Well right now I'm, I'm working so late, and everything is really, really stressful. So I don't really get much time to myself but, when I do wanna go out, or, you know, see friends or just relax. It, it seems quite difficult to do that.",
"speaker": "Patient"
},
{
"start": 351.82588,
"end": 356.2444,
"text": "OK, and , are you avoiding contact with friends, or do you still see them?",
"speaker": "Doctor"
},
{
"start": 356.80516,
"end": 368.6924,
"text": "I avoid them insomuch that I, feel like I'm. Yeah, so I mean sometimes it just, I know that I'm not gonna have fun, because I don't want to, go out and, do things that I would normally have done.",
"speaker": "Patient"
},
{
"start": 368.72298,
"end": 375.20129,
"text": "OK. What about, hobbies, or exercise, or anything else outside work? Do you do anything else outside work?",
"speaker": "Doctor"
},
{
"start": 375.12098,
"end": 394.512,
"text": "Yeah, as I say like everything that I had previously been doing has been, just difficult to continue with like, I did used to like to like go running, and. And to play tennis and stuff, but now it's just not, I'm just not enjoying it, I'm not, I'm not like, I'm not going out to do that quite so much.",
"speaker": "Patient"
},
{
"start": 394.21956,
"end": 397.70209,
"text": "And have you, has it ever got so bad that you've actually had to miss work?",
"speaker": "Doctor"
},
{
"start": 399.01008,
"end": 408.45187,
"text": "No, 'cause I think that would just add to the tension, but I do like pretty much every morning I think, ohh I should call in sick or like, just not go.",
"speaker": "Patient"
},
{
"start": 406.82385,
"end": 407.61467,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 409.6066,
"end": 422.61637,
"text": "And, what's the worst that it's got? Have you ever, been, um, so overwhelmed that you couldn't, get in to the office, you couldn't, go into a situation? Have you ever had a panic attack?",
"speaker": "Doctor"
},
{
"start": 420.76769,
"end": 422.03837,
"text": ", um.",
"speaker": "Patient"
},
{
"start": 424.03837,
"end": 441.1587,
"text": "No I wouldn't say so, I think, I've always managed to make it to work. But I, I wonder if it's building up. So this is why I wanted to call, I'm just worried it's building up to that, and I don't know what to do 'cause I have, feel it, felt it, get worse and worse over the past couple of months.",
"speaker": "Patient"
},
{
"start": 440.08317,
"end": 452.58816,
"text": "OK. And apart from work, are there any other situations which evoke quite extreme anxiety, like being, in public places, social situations, public transport, anything like that?",
"speaker": "Doctor"
},
{
"start": 452.63241,
"end": 467.52718,
"text": "Yeah I mean, I find public transport really stressful anyway, especially being on the tube it's, 'cause it's quite, getting warmer so it's just really airless. Um, but I think the majority of it, 'cause my life is just so focused around work right now, the majority of it is focused around work as well.",
"speaker": "Patient"
},
{
"start": 467.08747,
"end": 472.28157,
"text": "OK. Before this did you have any similar times in your life when you felt like this?",
"speaker": "Doctor"
},
{
"start": 473.50463,
"end": 485.55728,
"text": "Not really I, I'm, no, I would say. I mean everybody always has a bit of tension, a bit of anxiety but, I've never felt, anything this bad before.",
"speaker": "Patient"
},
{
"start": 485.5257,
"end": 494.17194,
"text": "OK. And what about your mood day-to-day? I mean, I can see that you're quite distressed by like that. Do you ever get really down about this?",
"speaker": "Doctor"
},
{
"start": 491.64752,
"end": 492.56481,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 494.71519,
"end": 518.42201,
"text": "Um, I mean, yeah, yeah, 'cause I do, yeah. I'm pretty much, down like, I don't enjoy, being and not just my day at all 'cause. I'm just so worried about everything, um, and I find that even when I'm not, like even at the weekends and stuff it's just the, kind of like constant, feeling of just being a bit, down, a bit unhappy.",
"speaker": "Patient"
},
{
"start": 518.07406,
"end": 520.44658,
"text": "When do you think you last felt yourself?",
"speaker": "Doctor"
},
{
"start": 522.42953,
"end": 523.38442,
"text": "Um.",
"speaker": "Patient"
},
{
"start": 525.67766,
"end": 529.86563,
"text": "I don't know, that's a good question, I can't really, I can't really put a on that at all.",
"speaker": "Patient"
},
{
"start": 528.83258,
"end": 540.55406,
"text": ". And has your mood ever been so low that you've felt like you just couldn't carry on with your job, or with your life, or with your normal, uh, things as they we're going on?",
"speaker": "Doctor"
},
{
"start": 540.70024,
"end": 560.82058,
"text": "I wouldn't, no I wouldn't say that I've had, I haven't had any suicidal thoughts or any, thoughts that have been that extreme like, I haven't. You know I have, I have a good support system, like I do have good family and stuff. So I, I have, I don't have, uh worries about, actually wanting to, um, not go on. It's just that, I don't wanna go on like this.",
"speaker": "Patient"
},
{
"start": 560.25953,
"end": 563.43772,
"text": "Yeah. OK. And where do you, who do you live with at home?",
"speaker": "Doctor"
},
{
"start": 563.97848,
"end": 564.8657,
"text": "Sorry?",
"speaker": "Patient"
},
{
"start": 564.61976,
"end": 566.25402,
"text": "Who do you live with at home?",
"speaker": "Doctor"
},
{
"start": 566.2266,
"end": 568.7454,
"text": "Yeah, I live with my parents, just my parents.",
"speaker": "Patient"
},
{
"start": 569.78942,
"end": 573.57442,
"text": "Um, and, how much alcohol do you have in an average week do you think?",
"speaker": "Doctor"
},
{
"start": 574.29428,
"end": 597.40711,
"text": "Um, ooh I don't know, probably quite a lot on the Friday or Saturday, just because, that, that's kind of normal, um. Uh, maybe I, maybe I do have like a bit during the week. Like, my parents obviously are retired, so they just drink whenever they want, so, whenever they're having a glass of wine, they'll offer it to me and it's like. I guess I don't really keep track of it that much.",
"speaker": "Patient"
},
{
"start": 597.59969,
"end": 600.73731,
"text": "OK. So, how much would you, would you guess?",
"speaker": "Doctor"
},
{
"start": 601.52742,
"end": 616.24925,
"text": "Probably like, probably quite a lot on a Friday or Saturday, because it's usually going out, so maybe like. I probably go over my limit just on those days, anyway, and then like, maybe a glass of wine during the week .",
"speaker": "Patient"
},
{
"start": 615.18323,
"end": 618.61472,
"text": "OK. Do you smoke or take any other drugs, or anything?",
"speaker": "Doctor"
},
{
"start": 619.39211,
"end": 624.67031,
"text": "Um, I try not to smoke, but I do, occasionally, but I don't take drugs.",
"speaker": "Patient"
},
{
"start": 624.52316,
"end": 636.4352,
"text": "OK. And have you done , anything yourself to help? Have you , have you talked to anyone, talked to any counsellors? Done any, online, looked online at all? Any ways to ?",
"speaker": "Doctor"
},
{
"start": 635.17409,
"end": 651.26183,
"text": "I, well I talk to my mum, because she also suffers from, well she's , suffered from like depression in the past. I didn't think that it was, that I was suffering from, actual depression because it just seems to be, manifesting as, as total , as just stress the whole time.",
"speaker": "Patient"
},
{
"start": 651.15456,
"end": 651.87344,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 651.26183,
"end": 658.73805,
"text": "But um, I did talk to my mum about it but I haven't sought any, she recommended that I come to the GP, um, but I haven't sought any other.",
"speaker": "Patient"
},
{
"start": 656.6242,
"end": 657.43062,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 659.41554,
"end": 664.06661,
"text": "And would you be happy to, have, some one-to-one therapy?",
"speaker": "Doctor"
},
{
"start": 659.62527,
"end": 660.45985,
"text": "",
"speaker": "Patient"
},
{
"start": 664.98617,
"end": 668.61024,
"text": "Yeah I think, yeah I think so. I've never done that before, but yeah.",
"speaker": "Patient"
},
{
"start": 668.19887,
"end": 691.55474,
"text": "OK. I mean what we would suggest in the first instance is to, to. So you can self-refer via the NHS, for what we call like, talking therapy which is a type of inter-behavioural, where they can really look at your situation. How you're reacting to, the, , why, what's provoking anxiety, and what you can do, to try and overcome that.",
"speaker": "Doctor"
},
{
"start": 679.90411,
"end": 681.0071,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 684.00125,
"end": 684.73057,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 691.55474,
"end": 706.77676,
"text": "Um, so I can send you the link for that. Um, in the meantimes it can be a bit of a wait. There are some online resources that are really helpful. Um, can put the details, on there and you can, get on with them straight away and try and work through them as well.",
"speaker": "Doctor"
},
{
"start": 700.21181,
"end": 701.07647,
"text": "Uh-huh.",
"speaker": "Patient"
},
{
"start": 706.77676,
"end": 726.1118,
"text": "Um, and if you're feeling like it's not helping at all, or your anxiety is getting worse, to the point where you can't cope with work, or you can't, just do your normal things day-to-day. Then, it's important for us to, for you to give us a call, back and just discuss that, further.",
"speaker": "Doctor"
},
{
"start": 706.99377,
"end": 708.24941,
"text": "OK. .",
"speaker": "Patient"
},
{
"start": 726.1118,
"end": 734.99138,
"text": "I mean some people, with anxiety they, do need to take medication to control that but that's, not something that we'd suggest in the first instance.",
"speaker": "Doctor"
},
{
"start": 735.47503,
"end": 736.27202,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 736.17869,
"end": 742.01414,
"text": "And I'll put some more information on your notes about, helping with your, sleep patterns and things like that.",
"speaker": "Doctor"
},
{
"start": 742.12917,
"end": 744.257,
"text": "That's great, I look forward to reading it.",
"speaker": "Patient"
},
{
"start": 743.88745,
"end": 760.77655,
"text": "Um, in terms of palpitations, it is most likely to be a, , associated with anxiety, but it's probably worth having couple of basic blood tests just to make sure that, there's not something triggering that off. And then arranging a GP follow-up a week after you've had the tests, so we can just go through the results with you.",
"speaker": "Doctor"
},
{
"start": 745.87354,
"end": 747.19685,
"text": "",
"speaker": "Patient"
},
{
"start": 761.03898,
"end": 764.15929,
"text": "OK, OK. Yeah, .",
"speaker": "Patient"
},
{
"start": 762.82043,
"end": 766.94116,
"text": "So if you call the support line you can arrange the, to have the blood test done.",
"speaker": "Doctor"
},
{
"start": 767.07658,
"end": 768.61794,
"text": "OK, I'll call them up.",
"speaker": "Patient"
},
{
"start": 768.68929,
"end": 769.41412,
"text": "OK?",
"speaker": "Doctor"
},
{
"start": 769.76831,
"end": 771.00892,
"text": "Thank you so much.",
"speaker": "Patient"
},
{
"start": 770.76485,
"end": 772.37694,
"text": "All right. Take care.",
"speaker": "Doctor"
},
{
"start": 772.45253,
"end": 773.97132,
"text": "Have a good day. Bye.",
"speaker": "Patient"
},
{
"start": 774.37105,
"end": 776.34,
"text": "Sorry. .",
"speaker": "Doctor"
}
],
"doctor_utterances": "Hi there. I'm Doctor Smith from Babylon. Hi there. Can you just confirm your name, date of birth, and the first line of your address, first of all please? My name's . OK. Are you in a private place where you can have a confidential consultation today? What can I do for you? OK. Do you mind just telling me a bit more about, when it started? Do you think there's something which changed in your life at that time? What's your job? OK. So, um, just day-to-day, tell me, from the start of your day, how it affects you. You said that you, you dread going to work. How, how does it affect you, in terms of like your sleep at night, and things like that? OK. So what time, what time do you go to bed at night-time? And what time do you get to sleep? OK. And, when you eventually get to sleep, do you wake up with your alarm in the morning, or does something else wake you up, before then? OK. And, so how many hours sleep do you think you get a night? OK. And, what about your eating patterns, any change in how you're eating, or whether you, your appetite's changed? OK. You're eating regularly otherwise? OK. And, you told me about the palpitations, just tell me a bit more about that. Does it feel like a regular fast beat, or an irregular, beat? And how long do you think it lasts for when you get it? OK. Is that something that you've had before this, or is that a new thing? OK. Any chest pain with that? OK. And, in the daytime, how, how, you said you, you're not getting much sleep so, how's your energy level in the daytime? OK. So what do you do in the evenings? OK, and , are you avoiding contact with friends, or do you still see them? OK. What about, hobbies, or exercise, or anything else outside work? Do you do anything else outside work? And have you, has it ever got so bad that you've actually had to miss work? OK. And, what's the worst that it's got? Have you ever, been, um, so overwhelmed that you couldn't, get in to the office, you couldn't, go into a situation? Have you ever had a panic attack? OK. And apart from work, are there any other situations which evoke quite extreme anxiety, like being, in public places, social situations, public transport, anything like that? OK. Before this did you have any similar times in your life when you felt like this? OK. And what about your mood day-to-day? I mean, I can see that you're quite distressed by like that. Do you ever get really down about this? When do you think you last felt yourself? . And has your mood ever been so low that you've felt like you just couldn't carry on with your job, or with your life, or with your normal, uh, things as they we're going on? Yeah. OK. And where do you, who do you live with at home? Who do you live with at home? Um, and, how much alcohol do you have in an average week do you think? OK. So, how much would you, would you guess? OK. Do you smoke or take any other drugs, or anything? OK. And have you done , anything yourself to help? Have you , have you talked to anyone, talked to any counsellors? Done any, online, looked online at all? Any ways to ? OK. OK. And would you be happy to, have, some one-to-one therapy? OK. I mean what we would suggest in the first instance is to, to. So you can self-refer via the NHS, for what we call like, talking therapy which is a type of inter-behavioural, where they can really look at your situation. How you're reacting to, the, , why, what's provoking anxiety, and what you can do, to try and overcome that. Um, so I can send you the link for that. Um, in the meantimes it can be a bit of a wait. There are some online resources that are really helpful. Um, can put the details, on there and you can, get on with them straight away and try and work through them as well. Um, and if you're feeling like it's not helping at all, or your anxiety is getting worse, to the point where you can't cope with work, or you can't, just do your normal things day-to-day. Then, it's important for us to, for you to give us a call, back and just discuss that, further. I mean some people, with anxiety they, do need to take medication to control that but that's, not something that we'd suggest in the first instance. And I'll put some more information on your notes about, helping with your, sleep patterns and things like that. Um, in terms of palpitations, it is most likely to be a, , associated with anxiety, but it's probably worth having couple of basic blood tests just to make sure that, there's not something triggering that off. And then arranging a GP follow-up a week after you've had the tests, so we can just go through the results with you. So if you call the support line you can arrange the, to have the blood test done. OK? All right. Take care. Sorry. .",
"patient_utterances": "Hi. Yeah. Uh, my name is Valerie Cole. My date of birth is the nineteenth of September, nineteen ninety three. My address is, uh, sixty four, Cliveden Place, in, South Wimbledon. Yes I am, yeah. Um, I've been feeling really anxious over the past few months. Um, I just get really nervous every morning about leaving the house, and it's started to really worry me, and just add up, and build up on that anxiety. And I just didn't know, who to talk to or, so I wanted to check with my GP. Um, I guess so, I think um, I would say maybe about two months or so, I've been feeling like this, and that probably coincides with, me starting a new job, um. Which I , I would say it's quite , I mean every job is stressful, and when you first start, but it's been really stressful I think over the past two months, definitely. Um, so I work for a, a, a fashion retailer, in um, the head office team, and it's just a brand new sector. I've never worked in retail before, my boss is not very nice to me and I don't. But I also think that, it's just been, I just really dread, going there. I just hate, speaking to her, I hate like seeing everyone and, really worried about whether I'm doing well or not. And it's really impacting on like, on the rest of my life, like my sleep and stuff like that. Right. Yeah, this is really so, I, I, I've, as I say like, I don't want to go to work in the morning, so I just find no way of, I can't get out of bed. But it's also because, when I leave I just, when I've left work, I just feel so stressed and so worried about everything I've done, I can't get to sleep for hours and hours and hours. So I. About ten, eleven, probably. Not for ages, I'm, I'm lying awake all night Mmm. So I find my, my heart kind of racing, and then I'm just like panicking that I'm gonna be late, and that that's gonna make work even more stressful. So I do have an alarm, but I find myself waking up before that, 'cause I'm just my heart is racing. And actually the other day, I was just like, I was lying in bed and I really thought my heart was racing so much, I thought I was gonna have a heart attack in the morning. , I just, I can't even tell because I feel like I'm, even when I'm in sleep it's such a shallow sleep, but maybe, three, four hours, I'm getting now. Probably, not, significant changes maybe. No I wouldn't say that, I wouldn't say that I'm eating like, much differently. Ohh that, I probably have more chocolate than normal, just because I feel, so down. Yeah, . Yeah, So um, it's, it's usually kind of like, when I realise in the morning that, either um, I feel like I'm gonna be late, because I've like overslept 'cause I'm so tired. Um, or I wake up in a panic thinking I am gonna be late so, it's just kind of like, just a constant like, rapid heart beating. It's just really, really stressful. I don't know if it's, stress or if, , or I did think it was like, a heart problem really actually. Irregular, I think. Ohh it can be anything, I think couple of minutes, or the other day I was actually just, sort of lying there for like, holding my hand on my chest for like ten minutes. Yeah, but I would say this is only in the past. Sort of like, couple of months as I say that I've been, experiencing this. No, um, well yeah it's painful to , when the heart, when my heart is beating fast but, but, yeah. It's just, really, really low, I mean I, I'm finding now that I'm just, I find no enjoyment at all. It's kind of day-to-day, and anything that I'm doing. It's not just my job it's, you know when I leave I'm just so tired that, anything that, previously was, really fun is just not, it's not enjoyable. And I'm like, yeah, on edge the whole time. Well right now I'm, I'm working so late, and everything is really, really stressful. So I don't really get much time to myself but, when I do wanna go out, or, you know, see friends or just relax. It, it seems quite difficult to do that. I avoid them insomuch that I, feel like I'm. Yeah, so I mean sometimes it just, I know that I'm not gonna have fun, because I don't want to, go out and, do things that I would normally have done. Yeah, as I say like everything that I had previously been doing has been, just difficult to continue with like, I did used to like to like go running, and. And to play tennis and stuff, but now it's just not, I'm just not enjoying it, I'm not, I'm not like, I'm not going out to do that quite so much. No, 'cause I think that would just add to the tension, but I do like pretty much every morning I think, ohh I should call in sick or like, just not go. , um. No I wouldn't say so, I think, I've always managed to make it to work. But I, I wonder if it's building up. So this is why I wanted to call, I'm just worried it's building up to that, and I don't know what to do 'cause I have, feel it, felt it, get worse and worse over the past couple of months. Yeah I mean, I find public transport really stressful anyway, especially being on the tube it's, 'cause it's quite, getting warmer so it's just really airless. Um, but I think the majority of it, 'cause my life is just so focused around work right now, the majority of it is focused around work as well. Not really I, I'm, no, I would say. I mean everybody always has a bit of tension, a bit of anxiety but, I've never felt, anything this bad before. Yeah. Um, I mean, yeah, yeah, 'cause I do, yeah. I'm pretty much, down like, I don't enjoy, being and not just my day at all 'cause. I'm just so worried about everything, um, and I find that even when I'm not, like even at the weekends and stuff it's just the, kind of like constant, feeling of just being a bit, down, a bit unhappy. Um. I don't know, that's a good question, I can't really, I can't really put a on that at all. I wouldn't, no I wouldn't say that I've had, I haven't had any suicidal thoughts or any, thoughts that have been that extreme like, I haven't. You know I have, I have a good support system, like I do have good family and stuff. So I, I have, I don't have, uh worries about, actually wanting to, um, not go on. It's just that, I don't wanna go on like this. Sorry? Yeah, I live with my parents, just my parents. Um, ooh I don't know, probably quite a lot on the Friday or Saturday, just because, that, that's kind of normal, um. Uh, maybe I, maybe I do have like a bit during the week. Like, my parents obviously are retired, so they just drink whenever they want, so, whenever they're having a glass of wine, they'll offer it to me and it's like. I guess I don't really keep track of it that much. Probably like, probably quite a lot on a Friday or Saturday, because it's usually going out, so maybe like. I probably go over my limit just on those days, anyway, and then like, maybe a glass of wine during the week . Um, I try not to smoke, but I do, occasionally, but I don't take drugs. I, well I talk to my mum, because she also suffers from, well she's , suffered from like depression in the past. I didn't think that it was, that I was suffering from, actual depression because it just seems to be, manifesting as, as total , as just stress the whole time. But um, I did talk to my mum about it but I haven't sought any, she recommended that I come to the GP, um, but I haven't sought any other. Yeah I think, yeah I think so. I've never done that before, but yeah. OK. Yeah. Uh-huh. OK. . OK. That's great, I look forward to reading it. OK, OK. Yeah, . OK, I'll call them up. Thank you so much. Have a good day. Bye.",
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"reference_note": "{\"day\": 5, \"consultation\": 3, \"presenting_complaint\": \"I'm feeling very anxious\", \"note\": \"PC: Anxiety symptoms\\nHPC: 2/12 hx feeling anxious all the time. Seems to have started when started new job. Different industry, pressures from boss. Dreads work every morning. Initial insomnia ++ 3hrs + EMW. Often has only 3-4 hrs sleep. Tired in the day. Low energy. Eating pattern normal but more chocolate. Anhedonia in work and outside. Previously enjoyed running, tennis, socialising. Now still sees friends but often avoids. \\nAssociated palpitations, only started with anxiety sx. Can feel irregular and chest discomfort. Rapid beat, lasts approx 2-10 mins.\\nNo panic attacks, not missed work.\\nOther anxiety provoking things include public transport.\\nLow mood most of the time but denies any suicidal ideation. \\n\\nPMH: Nil Past Psych hx/significant anxiety.\\nFHx: Mum has had depression.\\n\\nSH: Lives with parents. Supportive. Drinks Fri/sat, not sure of amount but sometimes overdoes it. Smokes occ, no illicit drugs.\\n\\nImp: Work related anxiety. Insomnia.\\n\\nPlan: Advised self referral to NHS talking therapies. In meantime advised to access online CBT: attached info.\\nIf anxiety/mood symptoms worse or unable to cope with work to contact us for further discussion.\\nAdvised blood test as initial investigation for palpitations. Patient advised to book via support team. \\n\", \"highlights\": [\"Anxiety symptoms\", \"insomnia\", \"Associated palpitations\", \"Low mood most of the time but denies any suicidal ideation\", \"Work related anxiety\"]}",
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"dialogue": "[Doctor] Hello. Hello, I'm Doctor Smith from Babylon.\n[Patient] Hello.\n[Patient] Hello, I'm .\n[Doctor] Hi there. Can you confirm your full name, date of birth, and the first line of your address please?\n[Patient] Okay.\n[Doctor] \n[Patient] My, my name is and I'm twenty, twenty three years old.\n[Doctor] \n[Doctor] \n[Doctor] Can you confirm your date of birth, and first line \n[Patient] nineteen ninety-six.\n[Doctor] OK. And your address?\n[Patient] And my address is, um, sixty .\n[Doctor] Yep. OK. And are you in a , are you in a private place where you can have a consultation?\n[Patient] Yes, definitely. Yes.\n[Doctor] OK. What can I do for you today?\n[Patient] yeah. Sorry, I, I, I can't hear you.\n[Doctor] What can I do for you today?\n[Patient] Um, I'm having really bad tummy ache. Like, at the bottom. At the lower bottom of my belly.\n[Doctor] \n[Doctor] Right, OK. And when did it start?\n[Patient] Few days ago, I was all well, was being well. Everything was O. K. Kind of, really, getting worse big time.\n[Doctor] \n[Doctor] OK. And whereabouts in your, in your abdomen do you think it is? Can you just explain to me whereabouts it is?\n[Patient] Yeah. It's like, lower. In my lower abdomen. Yeah.\n[Doctor] OK. And is it in the middle, or to one side?\n[Patient] No. It's, It's in the middle. Yeah.\n[Doctor] And, is it around your belly button, or above or below that?\n[Patient] Below. Mainly below.\n[Doctor] And is it there all the time, or does it come and go?\n[Patient] It's there all the time.\n[Doctor] OK. And what would you say it is on a scale of one to ten, with ten being the worst pain you've ever had?\n[Patient] It may be a eight.\n[Doctor] OK. Um, and have you, are you having any other symptoms with it?\n[Patient] Yeah, like. As in, like. I have, like, vaginal sometime bleeding. But, it's like light colour, and sometimes I'm constipated. Like \n[Doctor] K. So when, when was your last period?\n[Patient] My um, last month , two weeks ago. I'm sorry. About two weeks, two or three weeks ago.\n[Doctor] OK. And are you having sexual intercourse regularly?\n[Patient] Yes. Yes, I do. Four weeks ago. four days ago, sorry. I just had\n[Doctor] OK. Are you using any contraception?\n[Patient] Yes, I am. I usuallycome last one year. And it's called implant.\n[Doctor] OK. And, do you have your , do you have your periods when you, since you've been using the , Implanon? Do you have periods? regularly, or are they sporadic?\n[Patient] Yes, I do.\n[Patient] Close, they, they are spreading like, not the time. It changes. Yeah.\n[Doctor] Right. OK. And was your last period normal?\n[Patient] Yeah.\n[Doctor] And, any problems with nausea or vomiting?\n[Patient] Yeah, I feel like , I feel like vomiting, but I, I get nauseated, but I don't vomit.\n[Doctor] Right. And have you been eating and drinking OK?\n[Patient] Yeah. Yeah, my regular activities OK, yeah, but it's just very uncomfortable at times and .\n[Doctor] \n[Doctor] OK. And, have you opened your bowels normally?\n[Patient] \n[Doctor] Have you opened your bowels normally?\n[Patient] Um, yeah, last week, last week I had problems, but this week it seems to be.\n[Doctor] You've been to the toilet?\n[Doctor] What problems did you have last week?\n[Patient] Like, I was constipated for a week. Like, I was having problem.\n[Doctor] OK. And what about this week?\n[Patient] Yeah, that seems to be OK. It's, it's fine now, yeah.\n[Doctor] Are you going to the toilet every day? Um, is the stool normal, or diarrhea, or hard stool?\n[Patient] Yeah.\n[Patient] It's .\n[Patient] No, it's, it's. now, yeah, not like .\n[Doctor] Um, and you said you'd had some vaginal bleeding?\n[Patient] Yes, yes, I did.\n[Doctor] Is that, is your period stopped?\n[Patient] Yeah. My period stopped, like, last two weeks ago, but, and this is different, I can, I can see, because it's not really, like, dark, it's just light pink colour. So, I don't know what is it, I cannot say what exactly what it is but I .\n[Doctor] OK.\n[Doctor] Any abnormal discharge, other discharge, or just the slight bleeding?\n[Patient] Just very small, extra, like, a vaginal discharge, just.\n[Doctor] OK. Any difficulty breathing, or pain in your shoulders, or anything like that?\n[Doctor] No.\n[Doctor] And have you had a high temperature? Have you got a thermometer?\n[Patient] No, I don't. I, I should be OK .\n[Doctor] Do you feel feverish?\n[Patient] No.\n[Doctor] And do you feel faint when you stand up?\n[Patient] No.\n[Doctor] What have you been doing for the last few days? Have you been at work as normal, or, have to stay at home?\n[Patient] Yes, I have . I'm doing, I work regular other activities, like cooking and stuff, everything, but it seems OK when I get the pain. It's just very bad.\n[Doctor] OK. But you said the pain's constant, there all the time? Or is it getting worse from time to time?\n[Patient] It is getting worse. \n[Doctor] OK. Um, have you had any other um, medical problems in the past?\n[Patient] Yeah, I have allergy, I have amoxicillin . Amoxicillin allergy.\n[Doctor] Pardon?\n[Doctor] OK. Anything else? Have you had any operations?\n[Patient] \n[Patient] No.\n[Doctor] Have you had any pregnancies?\n[Patient] No.\n[Doctor] Have you taken a pregnancy test this time? when was that?\n[Patient] Yeah, I did. Yeah. Yeah, around like a month ago, yeah.\n[Doctor] OK. But not since you've had the abdominal pain?\n[Doctor] OK. And, any surgery in the past?\n[Doctor] Um, and what's your job day to day?\n[Patient] Yeah, I'm a teacher. School teacher.\n[Doctor] OK. And who do you live with at home?\n[Patient] My husband, and my husband's family.\n[Doctor] OK. And do you smoke or drink alcohol?\n[Patient] I don't know.\n[Doctor] You take any other drugs?\n[Patient] No.\n[Doctor] Have you been abroad recently?\n[Patient] Yes.\n[Doctor] Whereabouts to?\n[Patient] Out in the air.\n[Doctor] Pardon?\n[Patient] \n[Doctor] A year ago, not recently. No.\n[Doctor] Um, and any problems passing water?\n[Patient] No.\n[Doctor] Any pain, or strong smell, or having to go more often than normal?\n[Patient] So, I, I, I don't really, I have noticed that I don't really go up that high before, so, yeah, I do drink a lot though.\n[Doctor] Right, OK. And any , any weight loss or blood in the stool, or urine?\n[Patient] Yes. I have . As I said, I have some, I guess, discharge and pain. But, then I there's isn't a lot of discharge.\n[Doctor] \n[Doctor] . OK. Fine. Um, I think with the abdominal pain, as it's getting worse, and it's been going on for the last few days, um, it would be very helpful to be able to examine you properly. Would you be happy to have an examination with a doctor?\n[Patient] Yes, .\n[Doctor] OK. Um, so what we can do, is we can arrange a face to face examination where they can um, see you in a clinic and do a abdominal examination, and advise further from there when we got more of an idea what's causing the problem. Um, would you be happy to call the support line and arrange that appointment?\n[Patient] Yes.\n[Doctor] OK. That's fine. So we'll, we'll do that. In the meantime, if it gets a lot worse, um, or you, you're not holding any fluids down, um, then we should see you before then. Um, did you say your pregnancy test was a month ago?\n[Patient] Yes.\n[Doctor] OK. Um, um, your Implanon was just put in a year ago?\n[Patient] Yes.\n[Doctor] The other thing we would need to do is to, to do a pregnancy test today, if possible.\n[Patient] I will do it.\n[Doctor] So if you can do that today, and if it's positive we need to see you straight away, so give us a call back.\n[Patient] Yes.\n[Doctor] OK? Have you got any other questions?\n[Patient] \n[Doctor] Right, OK. So, if you call the support line and make an appointment, we'll go from there.\n[Patient] \n[Patient] Thank you, thank you, thank you very.\n[Doctor] Thanks. Bye.",
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"text": "Do you feel feverish?",
"speaker": "Doctor"
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{
"start": 301.29079,
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"text": "No.",
"speaker": "Patient"
},
{
"start": 303.21551,
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"text": "And do you feel faint when you stand up?",
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"start": 306.49591,
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"text": "No.",
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{
"start": 308.08437,
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"text": "What have you been doing for the last few days? Have you been at work as normal, or, have to stay at home?",
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{
"start": 312.12489,
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"text": " Yes, I have . I'm doing, I work regular other activities, like cooking and stuff, everything, but it seems OK when I get the pain. It's just very bad.",
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},
{
"start": 324.78447,
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"text": "OK. But you said the pain's constant, there all the time? Or is it getting worse from time to time?",
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"text": "It is getting worse. ",
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{
"start": 333.77303,
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"text": "OK. Um, have you had any other um, medical problems in the past?",
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{
"start": 340.04355,
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"text": "Yeah, I have allergy, I have amoxicillin . Amoxicillin allergy.",
"speaker": "Patient"
},
{
"start": 343.3715,
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"text": "Pardon?",
"speaker": "Doctor"
},
{
"start": 347.95915,
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"text": "OK. Anything else? Have you had any operations?",
"speaker": "Doctor"
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{
"start": 348.8939,
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"speaker": "Patient"
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{
"start": 352.72613,
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"text": "No.",
"speaker": "Patient"
},
{
"start": 353.63433,
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"text": "Have you had any pregnancies?",
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},
{
"start": 356.03486,
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"text": "No.",
"speaker": "Patient"
},
{
"start": 357.2828,
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"text": "Have you taken a pregnancy test this time? when was that?",
"speaker": "Doctor"
},
{
"start": 360.65718,
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"text": "Yeah, I did. Yeah. Yeah, around like a month ago, yeah.",
"speaker": "Patient"
},
{
"start": 367.53344,
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"text": "OK. But not since you've had the abdominal pain?",
"speaker": "Doctor"
},
{
"start": 374.28181,
"end": 377.88979,
"text": "OK. And, any surgery in the past?",
"speaker": "Doctor"
},
{
"start": 381.42273,
"end": 384.01607,
"text": "Um, and what's your job day to day?",
"speaker": "Doctor"
},
{
"start": 384.72537,
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"text": "Yeah, I'm a teacher. School teacher.",
"speaker": "Patient"
},
{
"start": 386.29034,
"end": 389.94078,
"text": " OK. And who do you live with at home?",
"speaker": "Doctor"
},
{
"start": 390.47903,
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"text": "My husband, and my husband's family.",
"speaker": "Patient"
},
{
"start": 394.05528,
"end": 397.39861,
"text": "OK. And do you smoke or drink alcohol?",
"speaker": "Doctor"
},
{
"start": 397.4742,
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"text": "I don't know.",
"speaker": "Patient"
},
{
"start": 398.25941,
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"text": "You take any other drugs?",
"speaker": "Doctor"
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{
"start": 400.65443,
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"text": "No.",
"speaker": "Patient"
},
{
"start": 401.31813,
"end": 403.22275,
"text": "Have you been abroad recently?",
"speaker": "Doctor"
},
{
"start": 403.61706,
"end": 404.14239,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 404.17061,
"end": 405.47275,
"text": "Whereabouts to?",
"speaker": "Doctor"
},
{
"start": 405.87979,
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"text": "Out in the air.",
"speaker": "Patient"
},
{
"start": 407.28434,
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"text": "Pardon?",
"speaker": "Doctor"
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{
"start": 408.59207,
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"text": "",
"speaker": "Patient"
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{
"start": 409.85447,
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"text": "A year ago, not recently. No.",
"speaker": "Doctor"
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{
"start": 415.68764,
"end": 418.4417,
"text": "Um, and any problems passing water?",
"speaker": "Doctor"
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{
"start": 419.28338,
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"text": "No.",
"speaker": "Patient"
},
{
"start": 420.0937,
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"text": "Any pain, or strong smell, or having to go more often than normal?",
"speaker": "Doctor"
},
{
"start": 424.52322,
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"text": "So, I, I, I don't really, I have noticed that I don't really go up that high before, so, yeah, I do drink a lot though.",
"speaker": "Patient"
},
{
"start": 433.30618,
"end": 438.96259,
"text": "Right, OK. And any , any weight loss or blood in the stool, or urine?",
"speaker": "Doctor"
},
{
"start": 439.78595,
"end": 449.60566,
"text": "Yes. I have . As I said, I have some, I guess, discharge and pain. But, then I there's isn't a lot of discharge.",
"speaker": "Patient"
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{
"start": 440.06053,
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"text": "",
"speaker": "Doctor"
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{
"start": 447.3327,
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"text": ". OK. Fine. Um, I think with the abdominal pain, as it's getting worse, and it's been going on for the last few days, um, it would be very helpful to be able to examine you properly. Would you be happy to have an examination with a doctor?",
"speaker": "Doctor"
},
{
"start": 465.54533,
"end": 466.32385,
"text": "Yes, .",
"speaker": "Patient"
},
{
"start": 466.6647,
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"text": "OK. Um, so what we can do, is we can arrange a face to face examination where they can um, see you in a clinic and do a abdominal examination, and advise further from there when we got more of an idea what's causing the problem. Um, would you be happy to call the support line and arrange that appointment?",
"speaker": "Doctor"
},
{
"start": 486.5924,
"end": 487.26354,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 488.15502,
"end": 507.63471,
"text": "OK. That's fine. So we'll, we'll do that. In the meantime, if it gets a lot worse, um, or you, you're not holding any fluids down, um, then we should see you before then. Um, did you say your pregnancy test was a month ago?",
"speaker": "Doctor"
},
{
"start": 507.72967,
"end": 508.62605,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 508.72398,
"end": 512.53001,
"text": "OK. Um, um, your Implanon was just put in a year ago?",
"speaker": "Doctor"
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{
"start": 513.3509,
"end": 514.06231,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 514.18325,
"end": 519.94054,
"text": "The other thing we would need to do is to, to do a pregnancy test today, if possible.",
"speaker": "Doctor"
},
{
"start": 521.23018,
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"text": "I will do it.",
"speaker": "Patient"
},
{
"start": 522.04135,
"end": 526.61154,
"text": "So if you can do that today, and if it's positive we need to see you straight away, so give us a call back.",
"speaker": "Doctor"
},
{
"start": 526.94155,
"end": 527.47846,
"text": "Yes.",
"speaker": "Patient"
},
{
"start": 529.17761,
"end": 532.19148,
"text": "OK? Have you got any other questions?",
"speaker": "Doctor"
},
{
"start": 532.42676,
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"text": "",
"speaker": "Patient"
},
{
"start": 534.30179,
"end": 538.80956,
"text": "Right, OK. So, if you call the support line and make an appointment, we'll go from there.",
"speaker": "Doctor"
},
{
"start": 535.72588,
"end": 536.66628,
"text": "",
"speaker": "Patient"
},
{
"start": 539.29541,
"end": 541.40136,
"text": "Thank you, thank you, thank you very.",
"speaker": "Patient"
},
{
"start": 539.7561,
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"text": "Thanks. Bye.",
"speaker": "Doctor"
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],
"doctor_utterances": "Hello. Hello, I'm Doctor Smith from Babylon. Hi there. Can you confirm your full name, date of birth, and the first line of your address please? Can you confirm your date of birth, and first line OK. And your address? Yep. OK. And are you in a , are you in a private place where you can have a consultation? OK. What can I do for you today? What can I do for you today? Right, OK. And when did it start? OK. And whereabouts in your, in your abdomen do you think it is? Can you just explain to me whereabouts it is? OK. And is it in the middle, or to one side? And, is it around your belly button, or above or below that? And is it there all the time, or does it come and go? OK. And what would you say it is on a scale of one to ten, with ten being the worst pain you've ever had? OK. Um, and have you, are you having any other symptoms with it? K. So when, when was your last period? OK. And are you having sexual intercourse regularly? OK. Are you using any contraception? OK. And, do you have your , do you have your periods when you, since you've been using the , Implanon? Do you have periods? regularly, or are they sporadic? Right. OK. And was your last period normal? And, any problems with nausea or vomiting? Right. And have you been eating and drinking OK? OK. And, have you opened your bowels normally? Have you opened your bowels normally? You've been to the toilet? What problems did you have last week? OK. And what about this week? Are you going to the toilet every day? Um, is the stool normal, or diarrhea, or hard stool? Um, and you said you'd had some vaginal bleeding? Is that, is your period stopped? OK. Any abnormal discharge, other discharge, or just the slight bleeding? OK. Any difficulty breathing, or pain in your shoulders, or anything like that? No. And have you had a high temperature? Have you got a thermometer? Do you feel feverish? And do you feel faint when you stand up? What have you been doing for the last few days? Have you been at work as normal, or, have to stay at home? OK. But you said the pain's constant, there all the time? Or is it getting worse from time to time? OK. Um, have you had any other um, medical problems in the past? Pardon? OK. Anything else? Have you had any operations? Have you had any pregnancies? Have you taken a pregnancy test this time? when was that? OK. But not since you've had the abdominal pain? OK. And, any surgery in the past? Um, and what's your job day to day? OK. And who do you live with at home? OK. And do you smoke or drink alcohol? You take any other drugs? Have you been abroad recently? Whereabouts to? Pardon? A year ago, not recently. No. Um, and any problems passing water? Any pain, or strong smell, or having to go more often than normal? Right, OK. And any , any weight loss or blood in the stool, or urine? . OK. Fine. Um, I think with the abdominal pain, as it's getting worse, and it's been going on for the last few days, um, it would be very helpful to be able to examine you properly. Would you be happy to have an examination with a doctor? OK. Um, so what we can do, is we can arrange a face to face examination where they can um, see you in a clinic and do a abdominal examination, and advise further from there when we got more of an idea what's causing the problem. Um, would you be happy to call the support line and arrange that appointment? OK. That's fine. So we'll, we'll do that. In the meantime, if it gets a lot worse, um, or you, you're not holding any fluids down, um, then we should see you before then. Um, did you say your pregnancy test was a month ago? OK. Um, um, your Implanon was just put in a year ago? The other thing we would need to do is to, to do a pregnancy test today, if possible. So if you can do that today, and if it's positive we need to see you straight away, so give us a call back. OK? Have you got any other questions? Right, OK. So, if you call the support line and make an appointment, we'll go from there. Thanks. Bye.",
"patient_utterances": "Hello. Hello, I'm . Okay. My, my name is and I'm twenty, twenty three years old. nineteen ninety-six. And my address is, um, sixty . Yes, definitely. Yes. yeah. Sorry, I, I, I can't hear you. Um, I'm having really bad tummy ache. Like, at the bottom. At the lower bottom of my belly. Few days ago, I was all well, was being well. Everything was O. K. Kind of, really, getting worse big time. Yeah. It's like, lower. In my lower abdomen. Yeah. No. It's, It's in the middle. Yeah. Below. Mainly below. It's there all the time. It may be a eight. Yeah, like. As in, like. I have, like, vaginal sometime bleeding. But, it's like light colour, and sometimes I'm constipated. Like My um, last month , two weeks ago. I'm sorry. About two weeks, two or three weeks ago. Yes. Yes, I do. Four weeks ago. four days ago, sorry. I just had Yes, I am. I usuallycome last one year. And it's called implant. Yes, I do. Close, they, they are spreading like, not the time. It changes. Yeah. Yeah. Yeah, I feel like , I feel like vomiting, but I, I get nauseated, but I don't vomit. Yeah. Yeah, my regular activities OK, yeah, but it's just very uncomfortable at times and . Um, yeah, last week, last week I had problems, but this week it seems to be. Like, I was constipated for a week. Like, I was having problem. Yeah, that seems to be OK. It's, it's fine now, yeah. Yeah. It's . No, it's, it's. now, yeah, not like . Yes, yes, I did. Yeah. My period stopped, like, last two weeks ago, but, and this is different, I can, I can see, because it's not really, like, dark, it's just light pink colour. So, I don't know what is it, I cannot say what exactly what it is but I . Just very small, extra, like, a vaginal discharge, just. No, I don't. I, I should be OK . No. No. Yes, I have . I'm doing, I work regular other activities, like cooking and stuff, everything, but it seems OK when I get the pain. It's just very bad. It is getting worse. Yeah, I have allergy, I have amoxicillin . Amoxicillin allergy. No. No. Yeah, I did. Yeah. Yeah, around like a month ago, yeah. Yeah, I'm a teacher. School teacher. My husband, and my husband's family. I don't know. No. Yes. Out in the air. No. So, I, I, I don't really, I have noticed that I don't really go up that high before, so, yeah, I do drink a lot though. Yes. I have . As I said, I have some, I guess, discharge and pain. But, then I there's isn't a lot of discharge. Yes, . Yes. Yes. Yes. I will do it. Yes. Thank you, thank you, thank you very.",
"num_turns": 135,
"reference_note": "{\"day\": 5, \"consultation\": 4, \"presenting_complaint\": \"Lower stomach pain\", \"note\": \"PC: Abdominal pain. HPC: Periumbilical pain, constant getting worse. Severity 8/10. Has had some light PV bleeding. No dysuria/frequency but some difficulty PUing. BO daily, normal stool. Constipation for a week last week. LMP 2 weeks ago. No other PV discharge. E&D ok. Not checked temp. Does not feel feverish. Not feeling faint. No DIB/shoulder tip pain. Nausea. No vomiting/diarrhoea. Last foreign travel 1 yr ago. \\nImplanon 1 yr ago. \\nPMH: Nil significant\\nDH: Nil. Allergic to amoxicillin\\nSH; Teacher, has been able to work as usual. Lives with parents. No smoker/alcohol/drugs.\\nImp: Abdominal pain ? cause. Needs to check preg test today and contact us immediately if pos. Urgent examination booked with Dr. To get in touch before if pain worse/new sx. \\n\", \"highlights\": [\"Periumbilical pain\", \"light PV bleeding\", \"difficulty PUing\", \"LMP 2 weeks ago\"]}",
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"dialogue": "[Doctor] Hi there, I'm Doctor Smith from Babylon.\n[Patient] \n[Doctor] Hi. Can you just confirm your name, date of birth and your address, please?\n[Patient] Yes. Italy. And,\n[Doctor] I see, sounds a bit . Um. Are you in a private place so you can have a consultation today?\n[Patient] Sorry?\n[Doctor] Are you in a private place so you can have a consultation today?\n[Patient] Uh, yes.\n[Doctor] What can I do for you?\n[Patient] So, I have had a pain in my lower tummy the last two days. I feel kind of hot and sweaty.\n[Doctor] \n[Doctor] OK. And any pain like this in the past?\n[Patient] Uh, not yet, no.\n[Doctor] OK, can you just describe to me whereabouts it is?\n[Patient] Um, so, I don't, what, sorry?\n[Doctor] Can you describe to me whereabouts the pain is? Is it, is it.\n[Patient] So it's my lower tummy.\n[Doctor] Yeah. Is it in the middle or to one side?\n[Patient] Uh, not, um, with a needle.\n[Doctor] In the middle, OK. And any other symptoms along that, with that? Have you had any nausea or any vomiting?\n[Patient] Uh, no. I'm just a bit nausea but no vomiting.\n[Doctor] OK. Any change in your bowel habit recently, or any diarrhoea? Constipation?\n[Patient] Uh, I had been constipated in, like, in the last, um, last week, but now it's fine. And, yeah, like \n[Doctor] to the toilet?\n[Patient] Sorry?\n[Doctor] When did you last go to the toilet?\n[Patient] Uh, like two hours ago.\n[Doctor] And was it normal?\n[Patient] Yeah.\n[Doctor] Any blood in the stool?\n[Patient] Um, so there was some, like, slight, uh, blood in the urine, but, like, it was a little bit pink but.\n[Doctor] OK. And has this ever happened in the past before?\n[Patient] Um, no.\n[Doctor] Right. Any pain when you pass water?\n[Patient] Uh, no, that's fine.\n[Doctor] Are you having to go more often than normal?\n[Patient] Uh, yeah, a little bit, but I wasn't drinking a lot in these days.\n[Doctor] Are you more thirsty than normal?\n[Patient] Uh, yeah.\n[Doctor] And you said you felt hot and cold. Have you measured your temperature?\n[Patient] Uh, yes, I measured it but it's fine, like, around thirty seven.\n[Doctor] What was it? Thirty seven. Have you measured it at any other time when it's been raised?\n[Patient] Yeah.\n[Patient] Sorry?\n[Doctor] Have you measured it at any other time when it's been raised?\n[Patient] Um, no, no, I just measured, like, one hour ago.\n[Doctor] OK, that's fine. And, are you getting any pain higher up in your stomach? Any acid coming up into your throat or anything like that?\n[Patient] No, no, but like just a bit of nausea but not vomiting.\n[Doctor] OK. And any other discharge below?\n[Patient] Uh, no.\n[Doctor] OK. Um, and have you been abroad recently?\n[Patient] Um, no, no.\n[Doctor] No. And no similar problems to this before?\n[Patient] No.\n[Doctor] Have you had any other medical problems in the past?\n[Patient] Um, no, no, nothing sore. I mean, depends what, like, normal stuff like cold, flu.\n[Doctor] OK, nothing significant. Any allergies to medications?\n[Patient] \n[Patient] Uh, yes, amoxycillin.\n[Doctor] OK. Do you take any regular medications?\n[Patient] Uh, no.\n[Doctor] Any over the counter medications?\n[Patient] No. I have had the just, the, uh, internal uh, contraceptive implant, but like, for one year, now, no more.\n[Doctor] OK. Um, and do you have regular periods?\n[Patient] Uh, yeah.\n[Doctor] Any bleeding in between periods or after intercourse?\n[Patient] Um, no, no, no.\n[Doctor] OK.\n[Patient] Just like \n[Doctor] Right. Um, and you haven't felt shivery or sweaty? You said you had felt a bit sweaty.\n[Patient] Yeah. , yeah.\n[Doctor] OK. And any, any back pain or strong smell to the urine?\n[Patient] Uh, no back pain. No, I typically don't suffer from back pain, so, no.\n[Doctor] Right, OK. Anyone in your family had any medical problems before?\n[Patient] Uh, so, actually my mom had the breast cancer. Uh, but, again, not so important. I mean, just, like, the beginning it was , uh, cured in time.\n[Doctor] OK.\n[Doctor] OK. And who do you live with at home?\n[Patient] Um, sorry?\n[Doctor] Who do you live with at home?\n[Patient] Uh, with my parents.\n[Doctor] And, do you smoke or drink alcohol regularly?\n[Patient] Uh, yes.\n[Doctor] How much in a normal week?\n[Patient] Uh, so, I don't smoke. I drink, I . Four times per week.\n[Doctor] And how much?\n[Patient] Uh, yeah, a beer like, per time, let's say. .\n[Doctor] \n[Doctor] What per time?\n[Patient] Uh, let's say a beer.\n[Doctor] OK.\n[Patient] Four times a week on average, yeah.\n[Doctor] Right, OK. Um, so, it, it may be possible that you might be having an infection in the urine.\n[Patient] Uh-huh.\n[Doctor] If you feel like you're, you're going, you're having a little bit of difficulty when you're passing urine.\n[Patient] Yeah.\n[Doctor] Um, it might be worth taking a three day course of antibiotics. To clear that. Um, but, if the pain is getting worse, or you have a high temperature or back pain or develop any new symptoms, we feel like it's not getting better, then, um, we should speak to you again, because we might need to see you face-to-face for an examination.\n[Patient] Uh-huh.\n[Patient] Uh-huh, OK.\n[Doctor] Um, have you allocated a pharmacy with Babylon?\n[Patient] Uh, yes.\n[Doctor] OK. So, are you happy to take a course of antibiotics, if I send it through to the pharmacy?\n[Patient] Uh, yeah, that's fine. If it helps, yeah. OK.\n[Doctor] OK, so I can do that for you. Start taking them as soon as you get them, it's just twice a day for three days. Um, if your pain's getting worse,\n[Patient] OK.\n[Doctor] um, or you've got new symptoms, just contact us straightaway, or if you're getting a recurrence of the same problem again.\n[Patient] Uh-huh, OK. Sure. OK.\n[Doctor] OK? Alright then, have you got any other questions?\n[Patient] Uh, no, that's fine. Yeah. Thank you. Thank you. Bye.\n[Doctor] OK, thanks a lot. Bye.",
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"text": "Can you describe to me whereabouts the pain is? Is it, is it.",
"speaker": "Doctor"
},
{
"start": 55.91882,
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"text": "So it's my lower tummy.",
"speaker": "Patient"
},
{
"start": 57.62701,
"end": 60.82317,
"text": "Yeah. Is it in the middle or to one side?",
"speaker": "Doctor"
},
{
"start": 61.58097,
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"text": "Uh, not, um, with a needle.",
"speaker": "Patient"
},
{
"start": 64.8466,
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"text": "In the middle, OK. And any other symptoms along that, with that? Have you had any nausea or any vomiting?",
"speaker": "Doctor"
},
{
"start": 72.65527,
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"text": "Uh, no. I'm just a bit nausea but no vomiting.",
"speaker": "Patient"
},
{
"start": 76.63705,
"end": 82.29123,
"text": "OK. Any change in your bowel habit recently, or any diarrhoea? Constipation?",
"speaker": "Doctor"
},
{
"start": 82.79714,
"end": 92.01333,
"text": "Uh, I had been constipated in, like, in the last, um, last week, but now it's fine. And, yeah, like ",
"speaker": "Patient"
},
{
"start": 90.27846,
"end": 93.07585,
"text": " to the toilet?",
"speaker": "Doctor"
},
{
"start": 93.39171,
"end": 93.90523,
"text": "Sorry?",
"speaker": "Patient"
},
{
"start": 93.74256,
"end": 95.67697,
"text": "When did you last go to the toilet?",
"speaker": "Doctor"
},
{
"start": 96.2836,
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"text": "Uh, like two hours ago.",
"speaker": "Patient"
},
{
"start": 97.95657,
"end": 99.36128,
"text": "And was it normal?",
"speaker": "Doctor"
},
{
"start": 99.63495,
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"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 100.30176,
"end": 102.27188,
"text": "Any blood in the stool?",
"speaker": "Doctor"
},
{
"start": 103.15521,
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"text": "Um, so there was some, like, slight, uh, blood in the urine, but, like, it was a little bit pink but.",
"speaker": "Patient"
},
{
"start": 112.63976,
"end": 115.88353,
"text": "OK. And has this ever happened in the past before?",
"speaker": "Doctor"
},
{
"start": 116.9646,
"end": 118.37816,
"text": "Um, no.",
"speaker": "Patient"
},
{
"start": 119.28799,
"end": 122.01397,
"text": "Right. Any pain when you pass water?",
"speaker": "Doctor"
},
{
"start": 122.9756,
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"text": "Uh, no, that's fine.",
"speaker": "Patient"
},
{
"start": 124.71019,
"end": 127.18024,
"text": "Are you having to go more often than normal?",
"speaker": "Doctor"
},
{
"start": 128.02679,
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"text": "Uh, yeah, a little bit, but I wasn't drinking a lot in these days.",
"speaker": "Patient"
},
{
"start": 133.76288,
"end": 135.88774,
"text": "Are you more thirsty than normal?",
"speaker": "Doctor"
},
{
"start": 136.41866,
"end": 137.31055,
"text": "Uh, yeah.",
"speaker": "Patient"
},
{
"start": 139.04223,
"end": 143.31563,
"text": "And you said you felt hot and cold. Have you measured your temperature?",
"speaker": "Doctor"
},
{
"start": 143.80378,
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"text": "Uh, yes, I measured it but it's fine, like, around thirty seven.",
"speaker": "Patient"
},
{
"start": 147.0891,
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"text": "What was it? Thirty seven. Have you measured it at any other time when it's been raised?",
"speaker": "Doctor"
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{
"start": 149.70918,
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"text": "Yeah.",
"speaker": "Patient"
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{
"start": 153.20242,
"end": 153.81053,
"text": "Sorry?",
"speaker": "Patient"
},
{
"start": 153.61234,
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"text": "Have you measured it at any other time when it's been raised?",
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{
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"text": "Um, no, no, I just measured, like, one hour ago.",
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{
"start": 160.67719,
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"text": "OK, that's fine. And, are you getting any pain higher up in your stomach? Any acid coming up into your throat or anything like that?",
"speaker": "Doctor"
},
{
"start": 169.20914,
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"text": "No, no, but like just a bit of nausea but not vomiting.",
"speaker": "Patient"
},
{
"start": 174.46144,
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"text": "OK. And any other discharge below?",
"speaker": "Doctor"
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{
"start": 179.08074,
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"text": "Uh, no.",
"speaker": "Patient"
},
{
"start": 180.6871,
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"text": "OK. Um, and have you been abroad recently?",
"speaker": "Doctor"
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{
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"text": "Um, no, no.",
"speaker": "Patient"
},
{
"start": 187.00204,
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"text": "No. And no similar problems to this before?",
"speaker": "Doctor"
},
{
"start": 190.99288,
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"text": "No.",
"speaker": "Patient"
},
{
"start": 191.44221,
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"text": "Have you had any other medical problems in the past?",
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{
"start": 195.26315,
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"text": "Um, no, no, nothing sore. I mean, depends what, like, normal stuff like cold, flu.",
"speaker": "Patient"
},
{
"start": 203.11958,
"end": 208.65473,
"text": "OK, nothing significant. Any allergies to medications?",
"speaker": "Doctor"
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{
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"text": "",
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},
{
"start": 208.83069,
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"text": "Uh, yes, amoxycillin.",
"speaker": "Patient"
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{
"start": 212.63055,
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"text": "OK. Do you take any regular medications?",
"speaker": "Doctor"
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{
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"text": "Uh, no.",
"speaker": "Patient"
},
{
"start": 216.33272,
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"text": "Any over the counter medications?",
"speaker": "Doctor"
},
{
"start": 218.50635,
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"text": "No. I have had the just, the, uh, internal uh, contraceptive implant, but like, for one year, now, no more.",
"speaker": "Patient"
},
{
"start": 229.39086,
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"text": "OK. Um, and do you have regular periods?",
"speaker": "Doctor"
},
{
"start": 235.10766,
"end": 236.10766,
"text": "Uh, yeah.",
"speaker": "Patient"
},
{
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"text": "Any bleeding in between periods or after intercourse?",
"speaker": "Doctor"
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{
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"text": "Um, no, no, no.",
"speaker": "Patient"
},
{
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"text": "OK.",
"speaker": "Doctor"
},
{
"start": 245.39143,
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"text": "Just like ",
"speaker": "Patient"
},
{
"start": 247.96072,
"end": 253.79941,
"text": "Right. Um, and you haven't felt shivery or sweaty? You said you had felt a bit sweaty.",
"speaker": "Doctor"
},
{
"start": 254.00628,
"end": 256.16168,
"text": "Yeah. , yeah.",
"speaker": "Patient"
},
{
"start": 255.87665,
"end": 260.01317,
"text": "OK. And any, any back pain or strong smell to the urine?",
"speaker": "Doctor"
},
{
"start": 261.04005,
"end": 266.53328,
"text": "Uh, no back pain. No, I typically don't suffer from back pain, so, no.",
"speaker": "Patient"
},
{
"start": 267.00052,
"end": 271.67863,
"text": "Right, OK. Anyone in your family had any medical problems before?",
"speaker": "Doctor"
},
{
"start": 272.09408,
"end": 284.66162,
"text": "Uh, so, actually my mom had the breast cancer. Uh, but, again, not so important. I mean, just, like, the beginning it was , uh, cured in time.",
"speaker": "Patient"
},
{
"start": 276.30913,
"end": 277.10082,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 283.76083,
"end": 286.58204,
"text": "OK. And who do you live with at home?",
"speaker": "Doctor"
},
{
"start": 287.62107,
"end": 289.06702,
"text": "Um, sorry?",
"speaker": "Patient"
},
{
"start": 289.11161,
"end": 290.75438,
"text": "Who do you live with at home?",
"speaker": "Doctor"
},
{
"start": 291.43863,
"end": 293.26971,
"text": "Uh, with my parents.",
"speaker": "Patient"
},
{
"start": 293.53392,
"end": 296.51582,
"text": "And, do you smoke or drink alcohol regularly?",
"speaker": "Doctor"
},
{
"start": 297.18187,
"end": 298.41835,
"text": "Uh, yes.",
"speaker": "Patient"
},
{
"start": 298.45023,
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"text": "How much in a normal week?",
"speaker": "Doctor"
},
{
"start": 300.58051,
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"text": "Uh, so, I don't smoke. I drink, I . Four times per week.",
"speaker": "Patient"
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{
"start": 307.05655,
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"text": "And how much?",
"speaker": "Doctor"
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{
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"text": "Uh, yeah, a beer like, per time, let's say. .",
"speaker": "Patient"
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{
"start": 312.76442,
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"text": "",
"speaker": "Doctor"
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{
"start": 315.80596,
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"text": "What per time?",
"speaker": "Doctor"
},
{
"start": 317.51291,
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"text": "Uh, let's say a beer.",
"speaker": "Patient"
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{
"start": 319.02604,
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"text": "OK.",
"speaker": "Doctor"
},
{
"start": 320.02643,
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"text": "Four times a week on average, yeah.",
"speaker": "Patient"
},
{
"start": 322.37111,
"end": 330.04885,
"text": "Right, OK. Um, so, it, it may be possible that you might be having an infection in the urine.",
"speaker": "Doctor"
},
{
"start": 330.74938,
"end": 331.55343,
"text": "Uh-huh.",
"speaker": "Patient"
},
{
"start": 331.43571,
"end": 337.73862,
"text": "If you feel like you're, you're going, you're having a little bit of difficulty when you're passing urine.",
"speaker": "Doctor"
},
{
"start": 338.20882,
"end": 338.89126,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 339.76825,
"end": 364.37271,
"text": "Um, it might be worth taking a three day course of antibiotics. To clear that. Um, but, if the pain is getting worse, or you have a high temperature or back pain or develop any new symptoms, we feel like it's not getting better, then, um, we should speak to you again, because we might need to see you face-to-face for an examination.",
"speaker": "Doctor"
},
{
"start": 346.40475,
"end": 347.19529,
"text": "Uh-huh.",
"speaker": "Patient"
},
{
"start": 364.7966,
"end": 366.52633,
"text": "Uh-huh, OK.",
"speaker": "Patient"
},
{
"start": 366.30116,
"end": 370.34245,
"text": "Um, have you allocated a pharmacy with Babylon?",
"speaker": "Doctor"
},
{
"start": 371.17497,
"end": 372.57361,
"text": "Uh, yes.",
"speaker": "Patient"
},
{
"start": 373.25888,
"end": 378.75236,
"text": "OK. So, are you happy to take a course of antibiotics, if I send it through to the pharmacy?",
"speaker": "Doctor"
},
{
"start": 379.26955,
"end": 382.48576,
"text": "Uh, yeah, that's fine. If it helps, yeah. OK.",
"speaker": "Patient"
},
{
"start": 382.54368,
"end": 391.67362,
"text": "OK, so I can do that for you. Start taking them as soon as you get them, it's just twice a day for three days. Um, if your pain's getting worse,",
"speaker": "Doctor"
},
{
"start": 388.47899,
"end": 389.21547,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 392.4177,
"end": 398.20282,
"text": "um, or you've got new symptoms, just contact us straightaway, or if you're getting a recurrence of the same problem again.",
"speaker": "Doctor"
},
{
"start": 398.48572,
"end": 402.12085,
"text": "Uh-huh, OK. Sure. OK.",
"speaker": "Patient"
},
{
"start": 400.45267,
"end": 403.92855,
"text": "OK? Alright then, have you got any other questions?",
"speaker": "Doctor"
},
{
"start": 404.16814,
"end": 409.08,
"text": "Uh, no, that's fine. Yeah. Thank you. Thank you. Bye.",
"speaker": "Patient"
},
{
"start": 405.79749,
"end": 408.25564,
"text": "OK, thanks a lot. Bye.",
"speaker": "Doctor"
}
],
"doctor_utterances": "Hi there, I'm Doctor Smith from Babylon. Hi. Can you just confirm your name, date of birth and your address, please? I see, sounds a bit . Um. Are you in a private place so you can have a consultation today? Are you in a private place so you can have a consultation today? What can I do for you? OK. And any pain like this in the past? OK, can you just describe to me whereabouts it is? Can you describe to me whereabouts the pain is? Is it, is it. Yeah. Is it in the middle or to one side? In the middle, OK. And any other symptoms along that, with that? Have you had any nausea or any vomiting? OK. Any change in your bowel habit recently, or any diarrhoea? Constipation? to the toilet? When did you last go to the toilet? And was it normal? Any blood in the stool? OK. And has this ever happened in the past before? Right. Any pain when you pass water? Are you having to go more often than normal? Are you more thirsty than normal? And you said you felt hot and cold. Have you measured your temperature? What was it? Thirty seven. Have you measured it at any other time when it's been raised? Have you measured it at any other time when it's been raised? OK, that's fine. And, are you getting any pain higher up in your stomach? Any acid coming up into your throat or anything like that? OK. And any other discharge below? OK. Um, and have you been abroad recently? No. And no similar problems to this before? Have you had any other medical problems in the past? OK, nothing significant. Any allergies to medications? OK. Do you take any regular medications? Any over the counter medications? OK. Um, and do you have regular periods? Any bleeding in between periods or after intercourse? OK. Right. Um, and you haven't felt shivery or sweaty? You said you had felt a bit sweaty. OK. And any, any back pain or strong smell to the urine? Right, OK. Anyone in your family had any medical problems before? OK. OK. And who do you live with at home? Who do you live with at home? And, do you smoke or drink alcohol regularly? How much in a normal week? And how much? What per time? OK. Right, OK. Um, so, it, it may be possible that you might be having an infection in the urine. If you feel like you're, you're going, you're having a little bit of difficulty when you're passing urine. Um, it might be worth taking a three day course of antibiotics. To clear that. Um, but, if the pain is getting worse, or you have a high temperature or back pain or develop any new symptoms, we feel like it's not getting better, then, um, we should speak to you again, because we might need to see you face-to-face for an examination. Um, have you allocated a pharmacy with Babylon? OK. So, are you happy to take a course of antibiotics, if I send it through to the pharmacy? OK, so I can do that for you. Start taking them as soon as you get them, it's just twice a day for three days. Um, if your pain's getting worse, um, or you've got new symptoms, just contact us straightaway, or if you're getting a recurrence of the same problem again. OK? Alright then, have you got any other questions? OK, thanks a lot. Bye.",
"patient_utterances": " Yes. Italy. And, Sorry? Uh, yes. So, I have had a pain in my lower tummy the last two days. I feel kind of hot and sweaty. Uh, not yet, no. Um, so, I don't, what, sorry? So it's my lower tummy. Uh, not, um, with a needle. Uh, no. I'm just a bit nausea but no vomiting. Uh, I had been constipated in, like, in the last, um, last week, but now it's fine. And, yeah, like Sorry? Uh, like two hours ago. Yeah. Um, so there was some, like, slight, uh, blood in the urine, but, like, it was a little bit pink but. Um, no. Uh, no, that's fine. Uh, yeah, a little bit, but I wasn't drinking a lot in these days. Uh, yeah. Uh, yes, I measured it but it's fine, like, around thirty seven. Yeah. Sorry? Um, no, no, I just measured, like, one hour ago. No, no, but like just a bit of nausea but not vomiting. Uh, no. Um, no, no. No. Um, no, no, nothing sore. I mean, depends what, like, normal stuff like cold, flu. Uh, yes, amoxycillin. Uh, no. No. I have had the just, the, uh, internal uh, contraceptive implant, but like, for one year, now, no more. Uh, yeah. Um, no, no, no. Just like Yeah. , yeah. Uh, no back pain. No, I typically don't suffer from back pain, so, no. Uh, so, actually my mom had the breast cancer. Uh, but, again, not so important. I mean, just, like, the beginning it was , uh, cured in time. Um, sorry? Uh, with my parents. Uh, yes. Uh, so, I don't smoke. I drink, I . Four times per week. Uh, yeah, a beer like, per time, let's say. . Uh, let's say a beer. Four times a week on average, yeah. Uh-huh. Yeah. Uh-huh. Uh-huh, OK. Uh, yes. Uh, yeah, that's fine. If it helps, yeah. OK. OK. Uh-huh, OK. Sure. OK. Uh, no, that's fine. Yeah. Thank you. Thank you. Bye.",
"num_turns": 109,
"reference_note": "{\"day\": 5, \"consultation\": 5, \"presenting_complaint\": \"My tummy hurts\", \"note\": \"PC: Abdo pain\\nHPC: 2/7 hx lower abdominal pain, central location. Has noticed some blood in the urine. Has check temp - 37. No back pain. Feels sweaty. More thirsty than normal, drinking well. No dysuria/freq. Constipated last week, now BO normally. No blood in stool. Last BO 2 hrs ago. No N&V, no dyspepsia. \\n\\nPMH : Nil \\nDH: Nil. Allergic to amoxicillin.\\nFMH: Mum had breast cancer, now in remission. \\nSH: Lives with parents. Non smoker. No drugs. Drinks 1 beer x 4/week.\\n\\nImp: ? UTI.\\nPlan: Advised 3/7 course Abx. Will pick up from pharmacy. To start asap. If develops temperature/persistent/worsening pain to call back or if recurrent similar sx. \\n\", \"highlights\": [\"lower abdominal pain\", \"blood in the urine\", \"temp - 37\", \"No back pain\", \"thirsty\"]}",
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{
"consultation_id": "day5_consultation06",
"dialogue": "[Patient] Hello?\n[Doctor] Hi there, it's Doctor Smith from Babylon.\n[Patient] Uh, hi, Doctor Smith.\n[Doctor] Hi there. Could you give me your full name, date of birth, and your, the first line of your address, please?\n[Patient] Um, I.\n[Doctor] \n[Patient] \n[Doctor] \n[Doctor] Your full name, date of birth, and your address, please? Yeah, OK.\n[Patient] Yeah, my name is Barbara . Um, and my date of birth, fourth October, nineteen eighty four.\n[Doctor] OK.\n[Patient] And address fifty Avenue.\n[Doctor] OK. Are you in a private place so you can have a confidential consultation today?\n[Patient] Yes, I am.\n[Doctor] What can I do for you?\n[Patient] Um, I've just been for the past couple of days. I've been having this serious diarrhoea and this really, Giving me trouble.\n[Doctor] OK. So when did it start?\n[Patient] It was three days ago. Now.\n[Doctor] OK. And when you say diarrhoea, what do you mean by that? Is it watery or just loose?\n[Patient] It's, it's, it's very loose but it started as being very watery.\n[Doctor] OK. And how many times are you going to the toilet?\n[Patient] I lost count, um. Today alone, I've been at least four time.\n[Doctor] OK. And any, any high temperatures? Are you feeling feverish?\n[Patient] Yes, I've been running a serious temperature. I'm literally boiling.\n[Doctor] Have you checked your temperature with a thermometer?\n[Patient] No, 'cause I've not got one but like, to the touch, I'm, like, literally roasting.\n[Doctor] OK. Um, and any nausea or vomiting?\n[Patient] Yes, I've been throwing up. I can't keep to, uh, I can't seem to be able to keep anything in me. Not even water, not even my tea, not even any liquid stuff. I've just been throwing up everything.\n[Doctor] OK. And when, when were you last sick?\n[Patient] Um, I was sick just after trying, uh, trying to have breakfast this morning, so maybe about two hours ago.\n[Doctor] OK. And have you been passing water OK?\n[Patient] Yeah, I've been, I've been, yeah, urinating OK. Is that what you mean, like?\n[Doctor] Yeah, yeah, urinating, yeah. Any, and what sort of color is the urine?\n[Patient] To be honest, I have a look so I really couldn't say.\n[Doctor] OK. OK. And when did you last pass urine, do you think?\n[Patient] Um.\n[Patient] an hour ago.\n[Doctor] OK. And any blood in the stool or in the urine that you've noticed?\n[Patient] No blood.\n[Doctor] OK. Any episodes like this before? How's your bowels normally?\n[Patient] Sorry, I didn't catch that.\n[Doctor] How is your bowels normally?\n[Patient] Ah, ah, my, my bowels is normally fine. I would normally go to the toilet every day. You know, in the morning, just once, yeah, and that's fine.\n[Doctor] OK. Any episodes of diarrhoea or constipation normally?\n[Patient] No.\n[Doctor] And is there anything you think might have triggered this off? Have you been abroad anywhere?\n[Patient] No, but then, um, my, um my brother, um, has actually been having similar symptoms, um, for the past, um, few days as well, and he does say like everyone in school's got this so, I, I don't know, that might, that might be something.\n[Doctor] So you've been in contact with him, have you?\n[Patient] Yes.\n[Doctor] OK. Um, and any other medical problems?\n[Patient] \n[Doctor] Have you had any other symptoms at the moment, like rash?\n[Patient] No, no rash, no, nothing that, um.\n[Doctor] No. OK. Um, any surgery before, or abdominal problems, or any other medical issues?\n[Patient] Well, apart from the fact that this one is giving me abdominal pains, no previous abdominal pains before. Obviously I get the odd, um, you know, menstrual cramps and all that but, you know, that's, you know, that comes and goes.\n[Doctor] Yeah.\n[Doctor] OK. And whereabouts is the pain that you're getting?\n[Patient] Um, it's kind of like towards my navel area, like I can't touch my navel area. It's just so sore. And it gets, yeah, it's almost like the center of my navel.\n[Doctor] \n[Doctor] Um, and does the pain come and go?\n[Patient] Yes, it does come. When it comes, I feel this strong urge to go to the, to the loo, and then and sort of like comes again, it comes and.\n[Doctor] OK. Um, and do you take any medication regularly?\n[Patient] Well, I, I take my, my vitamins, vitamin D, every day. That's about, that's about all that I regularly take.\n[Doctor] OK.\n[Doctor] And have you got a normal diet?\n[Patient] Yeah, I eat well, normally.\n[Doctor] Right. Do you smoke or drink alcohol?\n[Patient] Well, I don't smoke, but, you know, I have a pint from time to time.\n[Doctor] And do you take any other drugs?\n[Patient] No. Like I said, I only take, um, vitamins. And for my menstrual cramps, when they come, maybe I might take a, a, an ibuprofen just to ease the pain, but.\n[Doctor] And when was, when was your last period?\n[Patient] Um, two weeks ago.\n[Doctor] OK. Are you on any contraception?\n[Patient] No.\n[Doctor] Are you having regular sexual intercourse?\n[Patient] No.\n[Doctor] OK. Um, and what's your job?\n[Patient] Um, um, uh.\n[Patient] Um, uh. A graphics designer.\n[Doctor] Have you had to miss work because of this problem?\n[Patient] Well, yes, I've had to actually work from home today. I'm working from home today because I can't, I can't be out for work. \n[Doctor] OK. And who do you live with at home?\n[Patient] I live with my brother and my mum.\n[Doctor] OK. OK. And, um, have you tried anything yourself for this problem?\n[Patient] Well, I've tried a home remedy. Um, I've tried the, the, uh, ORS, you know, thing I bought from my, my local, my local, uh. Um.\n[Doctor] What? Could you just repeat that?\n[Patient] The ORS, the, the salt sugar ORS, um, um, mix, the salt sugar mix.\n[Doctor] OK. And how often have you been taking that?\n[Patient] Yeah.\n[Patient] I've taken that, I've taken that, like, um, three times a day for the past two days.\n[Doctor] OK. Um, and do you feel like your symptoms are easing off, or getting worse, or ?\n[Patient] I, I, I they're not getting any better, 'cause like I said, I've been, I've been vomiting literally everything I take, so, so I doubt that even that had, had the chance to work.\n[Doctor] Yeah.\n[Doctor] OK. Um. I mean, it sounds like, because your brother's had a similar thing, it sounds like it might be some, an infectious gastroenteritis that you've got, which is usually caused by a virus. But, it can be from something you've eaten, as well. Um. If the symptoms, they do normally start to settle by themselves with the oral rehydration salts. Um, if the symptoms are continuing to get worse, the key thing is that we want to make sure that you're hydrated enough. Um, sometimes you do require certain medication to help this, if it's, sometimes if it's caused by a bacteria. Um, what I would say, probably worth as it's been going on for a few days and you feel like it's not starting to ease off. I think it's probably important to get a sample of the stool, so we can make sure that you haven't got a nasty bacterial infection which needs specific treatment.\n[Patient] OK.\n[Doctor] Um, and we should also check that you're not getting dehydrated, because if you're, if you're not keeping fluid down, then you can get dehydrated. Um, so.\n[Patient] So, how, how do I, how do I get myself hydrated when I'm not able to even, like, drink water? I'm throwing up everything.\n[Doctor] Yeah. So you need to carry on with your rehydration salts, and just have very small amounts. It's a positive sign that you passed urine an hour ago. So, you're obviously still, um, hydrated enough to pass urine.\n[Patient] OK.\n[Doctor] But we, um, we should see you so that we can check your hydration and, um, get that sample sent off as soon as possible. 'cause if, if, if you come into the clinic, you can send that sample off straightaway. Otherwise, we would have to post it out to you which would take time.\n[Patient] OK.\n[Patient] Ohh, OK. So, when can I come to the clinic to have this done?\n[Doctor] Um, so we can, we can make you an urgent appointment, um, and then you can, you can get the sample sent off and we can check your hydration. Um, but if, in the meantime, you're feeling more unwell, then we would get you seen urgently in A and E.\n[Patient] OK.\n[Doctor] So you can call us back in the meantime.\n[Patient] OK. So, what I'll do is, yeah. If you could, please book me the appointment and, um, yeah, I'll see how I feel, um, for the end of the day. Hopefully I don't need to go to the A and E, and, um .\n[Doctor] Yeah. If you keep drinking, keep going with the rehydration salts. Just tiny sips constantly, to so that your stomach doesn't get overfilled and, and you vomit, so just tiny, tiny sips but just keep going with it. Um, and just have very simple food, if you're gonna have anything, like toast or biscuit or something really light like that. Avoid, um, fruit, vegetables, uh, milk, anything like that, which might just make it worse.\n[Patient] Mm-hmm.\n[Patient] OK.\n[Doctor] OK. So you'll have to book an appointment through the support line.\n[Patient] OK.\n[Patient] Yes, please.\n[Doctor] Right, OK. We'll do that for you.\n[Patient] \n[Doctor] OK, take care.\n[Patient] Thank you.\n[Doctor] Thanks, bye.\n[Patient] ",
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"text": "Hello?",
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"text": "Hi there, it's Doctor Smith from Babylon.",
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"text": "Uh, hi, Doctor Smith.",
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"text": "Hi there. Could you give me your full name, date of birth, and your, the first line of your address, please?",
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"text": "Your full name, date of birth, and your address, please? Yeah, OK.",
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"text": "Yeah, my name is Barbara . Um, and my date of birth, fourth October, nineteen eighty four.",
"speaker": "Patient"
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"text": "OK.",
"speaker": "Doctor"
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"text": "And address fifty Avenue.",
"speaker": "Patient"
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{
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"text": "OK. Are you in a private place so you can have a confidential consultation today?",
"speaker": "Doctor"
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"text": "Yes, I am.",
"speaker": "Patient"
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"speaker": "Doctor"
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"text": "Um, I've just been for the past couple of days. I've been having this serious diarrhoea and this really, Giving me trouble.",
"speaker": "Patient"
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{
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"text": "OK. So when did it start?",
"speaker": "Doctor"
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"text": "It was three days ago. Now.",
"speaker": "Patient"
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{
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"text": "OK. And when you say diarrhoea, what do you mean by that? Is it watery or just loose?",
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"text": "It's, it's, it's very loose but it started as being very watery.",
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"text": "OK. And how many times are you going to the toilet?",
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{
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"text": " I lost count, um. Today alone, I've been at least four time.",
"speaker": "Patient"
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{
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"text": "OK. And any, any high temperatures? Are you feeling feverish?",
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"text": "Yes, I've been running a serious temperature. I'm literally boiling.",
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"text": "No, 'cause I've not got one but like, to the touch, I'm, like, literally roasting.",
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"text": "OK. Um, and any nausea or vomiting?",
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"text": "Yes, I've been throwing up. I can't keep to, uh, I can't seem to be able to keep anything in me. Not even water, not even my tea, not even any liquid stuff. I've just been throwing up everything.",
"speaker": "Patient"
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"text": "OK. And when, when were you last sick?",
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"text": "OK. And have you been passing water OK?",
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"text": "Yeah, I've been, I've been, yeah, urinating OK. Is that what you mean, like?",
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"text": "Yeah, yeah, urinating, yeah. Any, and what sort of color is the urine?",
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"text": "OK. OK. And when did you last pass urine, do you think?",
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"text": "OK. And any blood in the stool or in the urine that you've noticed?",
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"text": "No blood.",
"speaker": "Patient"
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"start": 163.75278,
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"text": "OK. Any episodes like this before? How's your bowels normally?",
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"text": "Sorry, I didn't catch that.",
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"text": "Ah, ah, my, my bowels is normally fine. I would normally go to the toilet every day. You know, in the morning, just once, yeah, and that's fine.",
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"text": "OK. Any episodes of diarrhoea or constipation normally?",
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"text": "No, but then, um, my, um my brother, um, has actually been having similar symptoms, um, for the past, um, few days as well, and he does say like everyone in school's got this so, I, I don't know, that might, that might be something.",
"speaker": "Patient"
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"text": "So you've been in contact with him, have you?",
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"text": "Yes.",
"speaker": "Patient"
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"text": "OK. Um, and any other medical problems?",
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"text": "No, no rash, no, nothing that, um.",
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"text": "No. OK. Um, any surgery before, or abdominal problems, or any other medical issues?",
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"text": "Well, apart from the fact that this one is giving me abdominal pains, no previous abdominal pains before. Obviously I get the odd, um, you know, menstrual cramps and all that but, you know, that's, you know, that comes and goes.",
"speaker": "Patient"
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{
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"text": "Yeah.",
"speaker": "Doctor"
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{
"start": 246.39068,
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"text": "OK. And whereabouts is the pain that you're getting?",
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"text": "Um, it's kind of like towards my navel area, like I can't touch my navel area. It's just so sore. And it gets, yeah, it's almost like the center of my navel.",
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{
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"speaker": "Doctor"
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"text": "Um, and does the pain come and go?",
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"text": "Yes, it does come. When it comes, I feel this strong urge to go to the, to the loo, and then and sort of like comes again, it comes and.",
"speaker": "Patient"
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{
"start": 274.36215,
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"text": "OK. Um, and do you take any medication regularly?",
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{
"start": 280.60932,
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"text": "Well, I, I take my, my vitamins, vitamin D, every day. That's about, that's about all that I regularly take.",
"speaker": "Patient"
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{
"start": 285.18711,
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"text": "OK.",
"speaker": "Doctor"
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"start": 289.56746,
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"text": "And have you got a normal diet?",
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"text": "Yeah, I eat well, normally.",
"speaker": "Patient"
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{
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"text": "Right. Do you smoke or drink alcohol?",
"speaker": "Doctor"
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{
"start": 298.44393,
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"text": "Well, I don't smoke, but, you know, I have a pint from time to time.",
"speaker": "Patient"
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{
"start": 302.15994,
"end": 304.12757,
"text": "And do you take any other drugs?",
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{
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"text": "No. Like I said, I only take, um, vitamins. And for my menstrual cramps, when they come, maybe I might take a, a, an ibuprofen just to ease the pain, but.",
"speaker": "Patient"
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{
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"text": "And when was, when was your last period?",
"speaker": "Doctor"
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"text": "Um, two weeks ago.",
"speaker": "Patient"
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"text": "OK. Are you on any contraception?",
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"text": "No.",
"speaker": "Patient"
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{
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"text": "Are you having regular sexual intercourse?",
"speaker": "Doctor"
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{
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"end": 325.78982,
"text": "No.",
"speaker": "Patient"
},
{
"start": 325.6677,
"end": 330.10623,
"text": "OK. Um, and what's your job?",
"speaker": "Doctor"
},
{
"start": 331.03043,
"end": 333.16577,
"text": "Um, um, uh.",
"speaker": "Patient"
},
{
"start": 334.8199,
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"text": "Um, uh. A graphics designer.",
"speaker": "Patient"
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{
"start": 338.87946,
"end": 341.35025,
"text": "Have you had to miss work because of this problem?",
"speaker": "Doctor"
},
{
"start": 342.0154,
"end": 351.03796,
"text": "Well, yes, I've had to actually work from home today. I'm working from home today because I can't, I can't be out for work. ",
"speaker": "Patient"
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{
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"end": 353.13638,
"text": "OK. And who do you live with at home?",
"speaker": "Doctor"
},
{
"start": 354.01541,
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"text": "I live with my brother and my mum.",
"speaker": "Patient"
},
{
"start": 356.16045,
"end": 363.86458,
"text": "OK. OK. And, um, have you tried anything yourself for this problem?",
"speaker": "Doctor"
},
{
"start": 364.33873,
"end": 376.8425,
"text": "Well, I've tried a home remedy. Um, I've tried the, the, uh, ORS, you know, thing I bought from my, my local, my local, uh. Um.",
"speaker": "Patient"
},
{
"start": 376.31477,
"end": 378.01146,
"text": "What? Could you just repeat that?",
"speaker": "Doctor"
},
{
"start": 378.28611,
"end": 386.90266,
"text": "The ORS, the, the salt sugar ORS, um, um, mix, the salt sugar mix.",
"speaker": "Patient"
},
{
"start": 386.60407,
"end": 389.50061,
"text": "OK. And how often have you been taking that?",
"speaker": "Doctor"
},
{
"start": 387.61695,
"end": 388.24101,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 389.98537,
"end": 395.45154,
"text": "I've taken that, I've taken that, like, um, three times a day for the past two days.",
"speaker": "Patient"
},
{
"start": 395.73222,
"end": 405.24084,
"text": "OK. Um, and do you feel like your symptoms are easing off, or getting worse, or ?",
"speaker": "Doctor"
},
{
"start": 404.30869,
"end": 415.63202,
"text": " I, I, I they're not getting any better, 'cause like I said, I've been, I've been vomiting literally everything I take, so, so I doubt that even that had, had the chance to work.",
"speaker": "Patient"
},
{
"start": 411.62082,
"end": 412.33053,
"text": "Yeah.",
"speaker": "Doctor"
},
{
"start": 415.96246,
"end": 473.06618,
"text": "OK. Um. I mean, it sounds like, because your brother's had a similar thing, it sounds like it might be some, an infectious gastroenteritis that you've got, which is usually caused by a virus. But, it can be from something you've eaten, as well. Um. If the symptoms, they do normally start to settle by themselves with the oral rehydration salts. Um, if the symptoms are continuing to get worse, the key thing is that we want to make sure that you're hydrated enough. Um, sometimes you do require certain medication to help this, if it's, sometimes if it's caused by a bacteria. Um, what I would say, probably worth as it's been going on for a few days and you feel like it's not starting to ease off. I think it's probably important to get a sample of the stool, so we can make sure that you haven't got a nasty bacterial infection which needs specific treatment.",
"speaker": "Doctor"
},
{
"start": 473.48924,
"end": 474.48924,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 474.54354,
"end": 489.74848,
"text": "Um, and we should also check that you're not getting dehydrated, because if you're, if you're not keeping fluid down, then you can get dehydrated. Um, so.",
"speaker": "Doctor"
},
{
"start": 487.79001,
"end": 496.54942,
"text": "So, how, how do I, how do I get myself hydrated when I'm not able to even, like, drink water? I'm throwing up everything.",
"speaker": "Patient"
},
{
"start": 496.24457,
"end": 509.85592,
"text": "Yeah. So you need to carry on with your rehydration salts, and just have very small amounts. It's a positive sign that you passed urine an hour ago. So, you're obviously still, um, hydrated enough to pass urine.",
"speaker": "Doctor"
},
{
"start": 506.03063,
"end": 506.75244,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 509.85592,
"end": 529.99573,
"text": "But we, um, we should see you so that we can check your hydration and, um, get that sample sent off as soon as possible. 'cause if, if, if you come into the clinic, you can send that sample off straightaway. Otherwise, we would have to post it out to you which would take time.",
"speaker": "Doctor"
},
{
"start": 522.22614,
"end": 523.06073,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 530.54194,
"end": 534.26375,
"text": "Ohh, OK. So, when can I come to the clinic to have this done?",
"speaker": "Patient"
},
{
"start": 534.16953,
"end": 553.87044,
"text": "Um, so we can, we can make you an urgent appointment, um, and then you can, you can get the sample sent off and we can check your hydration. Um, but if, in the meantime, you're feeling more unwell, then we would get you seen urgently in A and E.",
"speaker": "Doctor"
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"text": "OK.",
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"text": "OK. So, what I'll do is, yeah. If you could, please book me the appointment and, um, yeah, I'll see how I feel, um, for the end of the day. Hopefully I don't need to go to the A and E, and, um .",
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"text": "Yeah. If you keep drinking, keep going with the rehydration salts. Just tiny sips constantly, to so that your stomach doesn't get overfilled and, and you vomit, so just tiny, tiny sips but just keep going with it. Um, and just have very simple food, if you're gonna have anything, like toast or biscuit or something really light like that. Avoid, um, fruit, vegetables, uh, milk, anything like that, which might just make it worse.",
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"text": "OK. So you'll have to book an appointment through the support line.",
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"doctor_utterances": "Hi there, it's Doctor Smith from Babylon. Hi there. Could you give me your full name, date of birth, and your, the first line of your address, please? Your full name, date of birth, and your address, please? Yeah, OK. OK. OK. Are you in a private place so you can have a confidential consultation today? What can I do for you? OK. So when did it start? OK. And when you say diarrhoea, what do you mean by that? Is it watery or just loose? OK. And how many times are you going to the toilet? OK. And any, any high temperatures? Are you feeling feverish? Have you checked your temperature with a thermometer? OK. Um, and any nausea or vomiting? OK. And when, when were you last sick? OK. And have you been passing water OK? Yeah, yeah, urinating, yeah. Any, and what sort of color is the urine? OK. OK. And when did you last pass urine, do you think? OK. And any blood in the stool or in the urine that you've noticed? OK. Any episodes like this before? How's your bowels normally? How is your bowels normally? OK. Any episodes of diarrhoea or constipation normally? And is there anything you think might have triggered this off? Have you been abroad anywhere? So you've been in contact with him, have you? OK. Um, and any other medical problems? Have you had any other symptoms at the moment, like rash? No. OK. Um, any surgery before, or abdominal problems, or any other medical issues? Yeah. OK. And whereabouts is the pain that you're getting? Um, and does the pain come and go? OK. Um, and do you take any medication regularly? OK. And have you got a normal diet? Right. Do you smoke or drink alcohol? And do you take any other drugs? And when was, when was your last period? OK. Are you on any contraception? Are you having regular sexual intercourse? OK. Um, and what's your job? Have you had to miss work because of this problem? OK. And who do you live with at home? OK. OK. And, um, have you tried anything yourself for this problem? What? Could you just repeat that? OK. And how often have you been taking that? OK. Um, and do you feel like your symptoms are easing off, or getting worse, or ? Yeah. OK. Um. I mean, it sounds like, because your brother's had a similar thing, it sounds like it might be some, an infectious gastroenteritis that you've got, which is usually caused by a virus. But, it can be from something you've eaten, as well. Um. If the symptoms, they do normally start to settle by themselves with the oral rehydration salts. Um, if the symptoms are continuing to get worse, the key thing is that we want to make sure that you're hydrated enough. Um, sometimes you do require certain medication to help this, if it's, sometimes if it's caused by a bacteria. Um, what I would say, probably worth as it's been going on for a few days and you feel like it's not starting to ease off. I think it's probably important to get a sample of the stool, so we can make sure that you haven't got a nasty bacterial infection which needs specific treatment. Um, and we should also check that you're not getting dehydrated, because if you're, if you're not keeping fluid down, then you can get dehydrated. Um, so. Yeah. So you need to carry on with your rehydration salts, and just have very small amounts. It's a positive sign that you passed urine an hour ago. So, you're obviously still, um, hydrated enough to pass urine. But we, um, we should see you so that we can check your hydration and, um, get that sample sent off as soon as possible. 'cause if, if, if you come into the clinic, you can send that sample off straightaway. Otherwise, we would have to post it out to you which would take time. Um, so we can, we can make you an urgent appointment, um, and then you can, you can get the sample sent off and we can check your hydration. Um, but if, in the meantime, you're feeling more unwell, then we would get you seen urgently in A and E. So you can call us back in the meantime. Yeah. If you keep drinking, keep going with the rehydration salts. Just tiny sips constantly, to so that your stomach doesn't get overfilled and, and you vomit, so just tiny, tiny sips but just keep going with it. Um, and just have very simple food, if you're gonna have anything, like toast or biscuit or something really light like that. Avoid, um, fruit, vegetables, uh, milk, anything like that, which might just make it worse. OK. So you'll have to book an appointment through the support line. Right, OK. We'll do that for you. OK, take care. Thanks, bye.",
"patient_utterances": "Hello? Uh, hi, Doctor Smith. Um, I. Yeah, my name is Barbara . Um, and my date of birth, fourth October, nineteen eighty four. And address fifty Avenue. Yes, I am. Um, I've just been for the past couple of days. I've been having this serious diarrhoea and this really, Giving me trouble. It was three days ago. Now. It's, it's, it's very loose but it started as being very watery. I lost count, um. Today alone, I've been at least four time. Yes, I've been running a serious temperature. I'm literally boiling. No, 'cause I've not got one but like, to the touch, I'm, like, literally roasting. Yes, I've been throwing up. I can't keep to, uh, I can't seem to be able to keep anything in me. Not even water, not even my tea, not even any liquid stuff. I've just been throwing up everything. Um, I was sick just after trying, uh, trying to have breakfast this morning, so maybe about two hours ago. Yeah, I've been, I've been, yeah, urinating OK. Is that what you mean, like? To be honest, I have a look so I really couldn't say. Um. an hour ago. No blood. Sorry, I didn't catch that. Ah, ah, my, my bowels is normally fine. I would normally go to the toilet every day. You know, in the morning, just once, yeah, and that's fine. No. No, but then, um, my, um my brother, um, has actually been having similar symptoms, um, for the past, um, few days as well, and he does say like everyone in school's got this so, I, I don't know, that might, that might be something. Yes. No, no rash, no, nothing that, um. Well, apart from the fact that this one is giving me abdominal pains, no previous abdominal pains before. Obviously I get the odd, um, you know, menstrual cramps and all that but, you know, that's, you know, that comes and goes. Um, it's kind of like towards my navel area, like I can't touch my navel area. It's just so sore. And it gets, yeah, it's almost like the center of my navel. Yes, it does come. When it comes, I feel this strong urge to go to the, to the loo, and then and sort of like comes again, it comes and. Well, I, I take my, my vitamins, vitamin D, every day. That's about, that's about all that I regularly take. Yeah, I eat well, normally. Well, I don't smoke, but, you know, I have a pint from time to time. No. Like I said, I only take, um, vitamins. And for my menstrual cramps, when they come, maybe I might take a, a, an ibuprofen just to ease the pain, but. Um, two weeks ago. No. No. Um, um, uh. Um, uh. A graphics designer. Well, yes, I've had to actually work from home today. I'm working from home today because I can't, I can't be out for work. I live with my brother and my mum. Well, I've tried a home remedy. Um, I've tried the, the, uh, ORS, you know, thing I bought from my, my local, my local, uh. Um. The ORS, the, the salt sugar ORS, um, um, mix, the salt sugar mix. Yeah. I've taken that, I've taken that, like, um, three times a day for the past two days. I, I, I they're not getting any better, 'cause like I said, I've been, I've been vomiting literally everything I take, so, so I doubt that even that had, had the chance to work. OK. So, how, how do I, how do I get myself hydrated when I'm not able to even, like, drink water? I'm throwing up everything. OK. OK. Ohh, OK. So, when can I come to the clinic to have this done? OK. OK. So, what I'll do is, yeah. If you could, please book me the appointment and, um, yeah, I'll see how I feel, um, for the end of the day. Hopefully I don't need to go to the A and E, and, um . Mm-hmm. OK. OK. Yes, please. Thank you. ",
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"reference_note": "{\"day\": 5, \"consultation\": 6, \"presenting_complaint\": \"Diarrhoea\", \"note\": \"PC: Diarrhoea\\nHPC: 3/7 hx diarrhoea. Watery stools. Urgency. No blood in stool. Periumbilical cramps, comes in waves. Worse when needs to open bowels. Very regular BO, today already 4 x by midday.\\nVomiting, last vomited 1 hr ago. Doesn't feel like she is holding down fluid.\\nStill PUing ok. Last 1 hr ago. Not sure of colour.\\nBH normally regular. 1 x day.\\nNo foreign travel. \\n\\n.\\nHas been taking ORT regularly, difficulty keeping down.\\nNo rash. Feels hot but hasn't checked temperature.\\nLMP 2/52 ago. No regular SI. Not using contraception. \\nHas been at work til today. Now working from home.\\n\\nPMH:Nil. DH: Vitamins.\\nSH: Lives with brother and mother. Non smoker. Drinks 1 pint a week.\\nWorks as graphic designer. \\n\\nImp: Gastroenteritis ?Viral/?food poisoning. \\nPlan: As ongoing, fever needs stool culture sent to exclude bacterial origin. Advised to continue taking small sips ORT constantly. Booked for urgent appointment to assess hydration status. If feels worse in meantime, abdo pain, unwell to contact us to arrange urgent A&E assessment.\\n\", \"highlights\": [\"3/7 hx diarrhoea\", \"No blood in stool\", \"Vomiting\", \"Still PUing ok\", \"Last 1 hr ago\"]}",
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"dialogue": "[Doctor] Hi there, it's Doctor Smith from Babylon.\n[Patient] Hello.\n[Patient] Hi there.\n[Doctor] Hi, can you confirm your name, date of birth and your home address, please?\n[Patient] Yeah, it's Matt Carter, and it's fourteenth of August, nineteen eighty nine, and what was the last bit?\n[Doctor] \n[Doctor] Your address.\n[Patient] And it's one Babylon Avenue.\n[Doctor] And are you in a private place where you can have a consultation today? What can I do for you?\n[Patient] Yes. Um, coming, I, I don't really know what's been going on, but it's just aching all over, but, definitely the last six weeks, it might have been slightly longer than that, but it's just sort of that, feeling really tired, run down.\n[Doctor] OK, um, so when do you think you were last well?\n[Patient] Uh, where are we now, we've just started April. I, definitely Christmas, New Year, I felt relatively well, I think. Um, so, since then. Actually, yeah, I, I was on holiday in, um, in the States. And yeah, it probably coincided with some time around then. End of January, start of Feb.\n[Doctor] So do you think it started when you were on holiday or after you got back?\n[Patient] Uh, probably a couple of weeks after I got back.\n[Doctor] Were you well when you were on holiday?\n[Patient] Yeah, had a had a great time, very active, uh.\n[Doctor] Did you get any infections, chest infections, diarrhoea, vomiting, anything like that?\n[Patient] Um, no, not that I recall. Um, yeah, not. No, the symptoms sort of all started afterwards.\n[Doctor] OK. So, just tell me what symptoms you've been having, in terms of just your general health. Any persistent cold symptoms or earaches, sore throat, chest cough, shortness of breath, phlegm, anything like that?\n[Patient] Uh, no.\n[Doctor] Any change in your weight at all?\n[Patient] Uh, I don't think so. Like, I'm probably less hungry, but no, no weight change, just a bit.\n[Doctor] OK, and are you eating different amounts?\n[Patient] Uh, yeah, probably slightly smaller portions, or it, yeah, more of an effort to, to actually eat everything that's in front of me.\n[Doctor] Any difficulty swallowing or acid in your throat, or abdominal pain?\n[Patient] No.\n[Doctor] Any change in your bowel habit, diarrhoea, vomiting or blood in the stool?\n[Patient] Uh, no.\n[Doctor] Any difficulty passing urine or blood in the urine?\n[Patient] No, that's all fine.\n[Doctor] OK, and any other general symptoms like rashes? Or.\n[Patient] Um, I don't have any rashes now, but there was, uh, in fact I've got a photo, um, on my phone if if that's helpful. I can try and show you, hang on. Um, because this, yeah, this was weird, this sort of came up, and then, uh.\n[Doctor] OK.\n[Doctor] OK.\n[Patient] Disappeared after a couple of weeks, where's the light, that, you see that?\n[Doctor] OK, right, yeah, whereabouts was it?\n[Patient] Uh, I think sort of calf, back of my calf, because I didn't notice it, my wife noticed it actually.\n[Doctor] When did you first notice it?\n[Patient] Um, probably, uh, around the end of February, the middle to end of Feb. And then it, like, it didn't actually cause too much itching, or anything, at the time. And, I, it faded over a couple of weeks, I guess.\n[Doctor] Did you have any fevers at that time?\n[Patient] Um, I, to be honest that actually turns out it was a bit of a sore throat I had, um, so possibly a little bit feverish, but I, I sort of put it down to that.\n[Doctor] Do you know where you got that, when it started? Had you been walking, did you get any bites that you noticed?\n[Patient] Uh, I like, I do quite a lot of walking, and we did, um, quite a lot while we were out in the, on holiday as well, but definitely, um. Yeah, I mean, I don't, I don't recall any bugs, I don't remember seeing anything bitten but you often, like, yeah, as you're walking through, I was in shorts and, and boots but /\n[Doctor] OK.\n[Doctor] Whereabouts were you in the States?\n[Patient] Um, just sort of, um, he examined me, so.\n[Doctor] OK, and any headaches, blurred vision, tingling, numbness?\n[Patient] Um, no. But it's the sort of headache maybe in just generally feeling a bit crappy. \n[Doctor] And have you been able to go to work as usual?\n[Patient] Um, I've been going to work. I don't know how effective it's been. But, yeah, been, been.\n[Doctor] And what's your job?\n[Patient] Um, I work for a health technology company actually.\n[Doctor] OK, and has your concentration been affected, or your tiredness levels in the daytime at work?\n[Patient] Yeah, definitely sort of tired and, um, yeah, less energy, sort of probably than I, I would normally be.\n[Doctor] \n[Doctor] Have you been able to exercise OK?\n[Patient] Um.\n[Patient] Not as much. I, I don't know if it's, I haven't been able to or I've just been a bit lazy with it. I I'm not exercising as I would normally.\n[Doctor] OK, fine, and, um, how's your mental health, your stress levels, all that?\n[Patient] Hey. Pretty good at the moment, actually. Like, it previously that has been an issue, but, um. Other than, sort of, physically feeling a bit. Uh, crappy, I've. Yeah, in a pretty good place.\n[Doctor] OK. Apart from that rash, any other rashes on your skin, or swelling of your joints, or pain in your joints?\n[Patient] Uh, yeah, sort of aching shoulders, back, the hips, knees, but sort of, yeah. Not ,\n[Doctor] Any swelling that you've noticed?\n[Patient] No, .\n[Doctor] Your hands, wrists, ankles, toes.\n[Patient] Uh, no.\n[Doctor] OK, um, and any other significant medical problems in the past?\n[Patient] Uh, I mean. \n[Doctor] Pardon?\n[Patient] Asthma and hay fever if they can help.\n[Doctor] OK. Any flare-ups of your asthma recently?\n[Patient] Uh, no, pretty well , I think.\n[Doctor] Do you take your regular inhalers or other medication?\n[Patient] Uh, yeah. I've got one of those, um, preventative, I think. Yeah , but I've not used one.\n[Doctor] You haven't been using it, you said?\n[Patient] I, I have it. I've been using the everyday for the morning and night but not the, uh, .\n[Doctor] OK. And any, erm, do you take any other medications?\n[Patient] Um, I take, um, one of the antihistamines it might be can I get that from, just from the pharmacy.\n[Doctor] Yeah, that's fine. Um, and do you smoke?\n[Patient] uh, .\n[Doctor] Drink any alcohol?\n[Doctor] No.\n[Patient] Sorry, occasionally, that was.\n[Doctor] OK, and who do you live with at home?\n[Patient] Uh, just my wife.\n[Doctor] Um.\n[Doctor] Sorry, um, so with this rash, we would need to investigate whether this has been a contributing factor to your symptoms. And just because of your symptoms, which have been ongoing for six weeks, that's obviously quite a long time to notice a change in your energy levels. Um, I think it's important to get some blood tests, checking all the normal things, like liver, kidneys, blood count, etc. But also, some more specific things like, um, a bacterial infection you can sometimes get, uh, including one which you can get which can produce a rash like that. So, that would involve blood tests. Are you happy to do that?\n[Patient] \n[Patient] Uh, yeah, I but, uh, what, what's the infection?\n[Doctor] Well, you can get, uh, you can get a bacterial infection caused which is called, um, it's called lyme disease that you can get a rash like that from a tick bite. So that's something we would do a test for, as well. Um, and if that comes back positive, then there are specific antibiotics that we would give you to treat it.\n[Patient] OK.\n[Patient] OK.\n[Doctor] So it's definitely worth checking for, but we would also check just for which can cause reduced energy, tiredness and aching for, persistent over six weeks.\n[Patient] OK.\n[Doctor] So if you're happy to do that, if you book that through the support line, and then when you've had the test arrange a follow up about a week after, after you've had the test done.\n[Patient] OK, so, do the test first and then, and that follow up we can just do over the phone again? Or, yeah.\n[Doctor] Um, yeah, we can do that over the phone to start with.\n[Patient] All right. Excellent.\n[Doctor] OK?\n[Patient] That, that's really helpful, thank you very much.\n[Doctor] \n[Patient] Oops, sorry, you broke up a bit there.\n[Doctor] Any other questions?\n[Patient] Ohh, no, not , no.\n[Doctor] OK, that's great. Take care.\n[Patient] OK, take care, thank you, bye.\n[Doctor] Sorry ",
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"text": "OK, right, yeah, whereabouts was it?",
"speaker": "Doctor"
},
{
"start": 195.13682,
"end": 201.20763,
"text": "Uh, I think sort of calf, back of my calf, because I didn't notice it, my wife noticed it actually.",
"speaker": "Patient"
},
{
"start": 201.04511,
"end": 202.93984,
"text": "When did you first notice it?",
"speaker": "Doctor"
},
{
"start": 204.03208,
"end": 222.63429,
"text": "Um, probably, uh, around the end of February, the middle to end of Feb. And then it, like, it didn't actually cause too much itching, or anything, at the time. And, I, it faded over a couple of weeks, I guess.",
"speaker": "Patient"
},
{
"start": 222.93984,
"end": 225.51127,
"text": "Did you have any fevers at that time?",
"speaker": "Doctor"
},
{
"start": 225.68599,
"end": 237.20466,
"text": "Um, I, to be honest that actually turns out it was a bit of a sore throat I had, um, so possibly a little bit feverish, but I, I sort of put it down to that.",
"speaker": "Patient"
},
{
"start": 237.8491,
"end": 244.34586,
"text": "Do you know where you got that, when it started? Had you been walking, did you get any bites that you noticed?",
"speaker": "Doctor"
},
{
"start": 244.73633,
"end": 264.70176,
"text": "Uh, I like, I do quite a lot of walking, and we did, um, quite a lot while we were out in the, on holiday as well, but definitely, um. Yeah, I mean, I don't, I don't recall any bugs, I don't remember seeing anything bitten but you often, like, yeah, as you're walking through, I was in shorts and, and boots but /",
"speaker": "Patient"
},
{
"start": 262.77443,
"end": 263.51127,
"text": "OK.",
"speaker": "Doctor"
},
{
"start": 265.62405,
"end": 267.52631,
"text": "Whereabouts were you in the States?",
"speaker": "Doctor"
},
{
"start": 267.92876,
"end": 272.41535,
"text": "Um, just sort of, um, he examined me, so.",
"speaker": "Patient"
},
{
"start": 272.33082,
"end": 277.86465,
"text": "OK, and any headaches, blurred vision, tingling, numbness?",
"speaker": "Doctor"
},
{
"start": 278.36279,
"end": 288.23232,
"text": "Um, no. But it's the sort of headache maybe in just generally feeling a bit crappy. ",
"speaker": "Patient"
},
{
"start": 289.203,
"end": 292.25563,
"text": "And have you been able to go to work as usual?",
"speaker": "Doctor"
},
{
"start": 292.56957,
"end": 299.3221,
"text": "Um, I've been going to work. I don't know how effective it's been. But, yeah, been, been.",
"speaker": "Patient"
},
{
"start": 298.13533,
"end": 300.24811,
"text": "And what's your job?",
"speaker": "Doctor"
},
{
"start": 299.98448,
"end": 302.98424,
"text": "Um, I work for a health technology company actually.",
"speaker": "Patient"
},
{
"start": 303.00751,
"end": 309.30074,
"text": "OK, and has your concentration been affected, or your tiredness levels in the daytime at work?",
"speaker": "Doctor"
},
{
"start": 309.5355,
"end": 319.3918,
"text": "Yeah, definitely sort of tired and, um, yeah, less energy, sort of probably than I, I would normally be.",
"speaker": "Patient"
},
{
"start": 315.83458,
"end": 317.45112,
"text": "",
"speaker": "Doctor"
},
{
"start": 319.31578,
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"text": "Have you been able to exercise OK?",
"speaker": "Doctor"
},
{
"start": 322.29416,
"end": 323.60581,
"text": "Um.",
"speaker": "Patient"
},
{
"start": 325.48882,
"end": 334.07879,
"text": "Not as much. I, I don't know if it's, I haven't been able to or I've just been a bit lazy with it. I I'm not exercising as I would normally.",
"speaker": "Patient"
},
{
"start": 333.72179,
"end": 342.0827,
"text": "OK, fine, and, um, how's your mental health, your stress levels, all that?",
"speaker": "Doctor"
},
{
"start": 340.8573,
"end": 356.33702,
"text": "Hey. Pretty good at the moment, actually. Like, it previously that has been an issue, but, um. Other than, sort of, physically feeling a bit. Uh, crappy, I've. Yeah, in a pretty good place.",
"speaker": "Patient"
},
{
"start": 356.30074,
"end": 362.76691,
"text": "OK. Apart from that rash, any other rashes on your skin, or swelling of your joints, or pain in your joints?",
"speaker": "Doctor"
},
{
"start": 363.07657,
"end": 371.77042,
"text": "Uh, yeah, sort of aching shoulders, back, the hips, knees, but sort of, yeah. Not ,",
"speaker": "Patient"
},
{
"start": 370.35337,
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"text": "Any swelling that you've noticed?",
"speaker": "Doctor"
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{
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"text": "No, .",
"speaker": "Patient"
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{
"start": 374.09021,
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"text": "Your hands, wrists, ankles, toes.",
"speaker": "Doctor"
},
{
"start": 377.23116,
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"text": "Uh, no.",
"speaker": "Patient"
},
{
"start": 378.55638,
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"text": "OK, um, and any other significant medical problems in the past?",
"speaker": "Doctor"
},
{
"start": 385.53558,
"end": 389.71725,
"text": "Uh, I mean. ",
"speaker": "Patient"
},
{
"start": 389.90224,
"end": 390.90224,
"text": "Pardon?",
"speaker": "Doctor"
},
{
"start": 390.938,
"end": 393.5352,
"text": "Asthma and hay fever if they can help.",
"speaker": "Patient"
},
{
"start": 393.76691,
"end": 396.38345,
"text": "OK. Any flare-ups of your asthma recently?",
"speaker": "Doctor"
},
{
"start": 396.944,
"end": 400.11256,
"text": "Uh, no, pretty well , I think.",
"speaker": "Patient"
},
{
"start": 399.19548,
"end": 402.29322,
"text": "Do you take your regular inhalers or other medication?",
"speaker": "Doctor"
},
{
"start": 402.57991,
"end": 410.21546,
"text": "Uh, yeah. I've got one of those, um, preventative, I think. Yeah , but I've not used one.",
"speaker": "Patient"
},
{
"start": 410.79698,
"end": 412.65412,
"text": "You haven't been using it, you said?",
"speaker": "Doctor"
},
{
"start": 412.29325,
"end": 418.29263,
"text": "I, I have it. I've been using the everyday for the morning and night but not the, uh, .",
"speaker": "Patient"
},
{
"start": 418.84961,
"end": 424.17292,
"text": "OK. And any, erm, do you take any other medications?",
"speaker": "Doctor"
},
{
"start": 425.03218,
"end": 438.75052,
"text": "Um, I take, um, one of the antihistamines it might be can I get that from, just from the pharmacy.",
"speaker": "Patient"
},
{
"start": 438.48119,
"end": 441.9248,
"text": "Yeah, that's fine. Um, and do you smoke?",
"speaker": "Doctor"
},
{
"start": 442.20522,
"end": 446.648,
"text": " uh, .",
"speaker": "Patient"
},
{
"start": 443.21051,
"end": 444.65412,
"text": "Drink any alcohol?",
"speaker": "Doctor"
},
{
"start": 448.20299,
"end": 449.06766,
"text": "No.",
"speaker": "Doctor"
},
{
"start": 449.47245,
"end": 451.21911,
"text": "Sorry, occasionally, that was.",
"speaker": "Patient"
},
{
"start": 451.22555,
"end": 453.57893,
"text": "OK, and who do you live with at home?",
"speaker": "Doctor"
},
{
"start": 453.77736,
"end": 454.94617,
"text": "Uh, just my wife.",
"speaker": "Patient"
},
{
"start": 456.22555,
"end": 457.406,
"text": "Um.",
"speaker": "Doctor"
},
{
"start": 459.43608,
"end": 500.93983,
"text": "Sorry, um, so with this rash, we would need to investigate whether this has been a contributing factor to your symptoms. And just because of your symptoms, which have been ongoing for six weeks, that's obviously quite a long time to notice a change in your energy levels. Um, I think it's important to get some blood tests, checking all the normal things, like liver, kidneys, blood count, etc. But also, some more specific things like, um, a bacterial infection you can sometimes get, uh, including one which you can get which can produce a rash like that. So, that would involve blood tests. Are you happy to do that?",
"speaker": "Doctor"
},
{
"start": 482.59224,
"end": 483.59224,
"text": "",
"speaker": "Patient"
},
{
"start": 501.68104,
"end": 506.60263,
"text": "Uh, yeah, I but, uh, what, what's the infection?",
"speaker": "Patient"
},
{
"start": 506.82705,
"end": 529.95487,
"text": "Well, you can get, uh, you can get a bacterial infection caused which is called, um, it's called lyme disease that you can get a rash like that from a tick bite. So that's something we would do a test for, as well. Um, and if that comes back positive, then there are specific antibiotics that we would give you to treat it.",
"speaker": "Doctor"
},
{
"start": 518.88695,
"end": 519.78307,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 523.55545,
"end": 524.41261,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 530.71427,
"end": 540.1654,
"text": "So it's definitely worth checking for, but we would also check just for which can cause reduced energy, tiredness and aching for, persistent over six weeks.",
"speaker": "Doctor"
},
{
"start": 540.67696,
"end": 541.50815,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 542.01502,
"end": 551.57141,
"text": "So if you're happy to do that, if you book that through the support line, and then when you've had the test arrange a follow up about a week after, after you've had the test done.",
"speaker": "Doctor"
},
{
"start": 552.27967,
"end": 559.63628,
"text": "OK, so, do the test first and then, and that follow up we can just do over the phone again? Or, yeah.",
"speaker": "Patient"
},
{
"start": 558.30073,
"end": 561.78946,
"text": "Um, yeah, we can do that over the phone to start with.",
"speaker": "Doctor"
},
{
"start": 561.52578,
"end": 563.12311,
"text": "All right. Excellent.",
"speaker": "Patient"
},
{
"start": 563.1654,
"end": 564.2857,
"text": "OK?",
"speaker": "Doctor"
},
{
"start": 564.79835,
"end": 567.15533,
"text": "That, that's really helpful, thank you very much.",
"speaker": "Patient"
},
{
"start": 565.84961,
"end": 567.43607,
"text": "",
"speaker": "Doctor"
},
{
"start": 568.21376,
"end": 570.53827,
"text": "Oops, sorry, you broke up a bit there.",
"speaker": "Patient"
},
{
"start": 569.6466,
"end": 571.15036,
"text": "Any other questions?",
"speaker": "Doctor"
},
{
"start": 571.23312,
"end": 572.84343,
"text": "Ohh, no, not , no.",
"speaker": "Patient"
},
{
"start": 573.01502,
"end": 575.31577,
"text": "OK, that's great. Take care.",
"speaker": "Doctor"
},
{
"start": 574.75241,
"end": 577.31066,
"text": "OK, take care, thank you, bye.",
"speaker": "Patient"
},
{
"start": 577.609,
"end": 578.99998,
"text": "Sorry ",
"speaker": "Doctor"
}
],
"doctor_utterances": " Hi there, it's Doctor Smith from Babylon. Hi, can you confirm your name, date of birth and your home address, please? Your address. And are you in a private place where you can have a consultation today? What can I do for you? OK, um, so when do you think you were last well? So do you think it started when you were on holiday or after you got back? Were you well when you were on holiday? Did you get any infections, chest infections, diarrhoea, vomiting, anything like that? OK. So, just tell me what symptoms you've been having, in terms of just your general health. Any persistent cold symptoms or earaches, sore throat, chest cough, shortness of breath, phlegm, anything like that? Any change in your weight at all? OK, and are you eating different amounts? Any difficulty swallowing or acid in your throat, or abdominal pain? Any change in your bowel habit, diarrhoea, vomiting or blood in the stool? Any difficulty passing urine or blood in the urine? OK, and any other general symptoms like rashes? Or. OK. OK. OK, right, yeah, whereabouts was it? When did you first notice it? Did you have any fevers at that time? Do you know where you got that, when it started? Had you been walking, did you get any bites that you noticed? OK. Whereabouts were you in the States? OK, and any headaches, blurred vision, tingling, numbness? And have you been able to go to work as usual? And what's your job? OK, and has your concentration been affected, or your tiredness levels in the daytime at work? Have you been able to exercise OK? OK, fine, and, um, how's your mental health, your stress levels, all that? OK. Apart from that rash, any other rashes on your skin, or swelling of your joints, or pain in your joints? Any swelling that you've noticed? Your hands, wrists, ankles, toes. OK, um, and any other significant medical problems in the past? Pardon? OK. Any flare-ups of your asthma recently? Do you take your regular inhalers or other medication? You haven't been using it, you said? OK. And any, erm, do you take any other medications? Yeah, that's fine. Um, and do you smoke? Drink any alcohol? No. OK, and who do you live with at home? Um. Sorry, um, so with this rash, we would need to investigate whether this has been a contributing factor to your symptoms. And just because of your symptoms, which have been ongoing for six weeks, that's obviously quite a long time to notice a change in your energy levels. Um, I think it's important to get some blood tests, checking all the normal things, like liver, kidneys, blood count, etc. But also, some more specific things like, um, a bacterial infection you can sometimes get, uh, including one which you can get which can produce a rash like that. So, that would involve blood tests. Are you happy to do that? Well, you can get, uh, you can get a bacterial infection caused which is called, um, it's called lyme disease that you can get a rash like that from a tick bite. So that's something we would do a test for, as well. Um, and if that comes back positive, then there are specific antibiotics that we would give you to treat it. So it's definitely worth checking for, but we would also check just for which can cause reduced energy, tiredness and aching for, persistent over six weeks. So if you're happy to do that, if you book that through the support line, and then when you've had the test arrange a follow up about a week after, after you've had the test done. Um, yeah, we can do that over the phone to start with. OK? Any other questions? OK, that's great. Take care. Sorry ",
"patient_utterances": "Hello. Hi there. Yeah, it's Matt Carter, and it's fourteenth of August, nineteen eighty nine, and what was the last bit? And it's one Babylon Avenue. Yes. Um, coming, I, I don't really know what's been going on, but it's just aching all over, but, definitely the last six weeks, it might have been slightly longer than that, but it's just sort of that, feeling really tired, run down. Uh, where are we now, we've just started April. I, definitely Christmas, New Year, I felt relatively well, I think. Um, so, since then. Actually, yeah, I, I was on holiday in, um, in the States. And yeah, it probably coincided with some time around then. End of January, start of Feb. Uh, probably a couple of weeks after I got back. Yeah, had a had a great time, very active, uh. Um, no, not that I recall. Um, yeah, not. No, the symptoms sort of all started afterwards. Uh, no. Uh, I don't think so. Like, I'm probably less hungry, but no, no weight change, just a bit. Uh, yeah, probably slightly smaller portions, or it, yeah, more of an effort to, to actually eat everything that's in front of me. No. Uh, no. No, that's all fine. Um, I don't have any rashes now, but there was, uh, in fact I've got a photo, um, on my phone if if that's helpful. I can try and show you, hang on. Um, because this, yeah, this was weird, this sort of came up, and then, uh. Disappeared after a couple of weeks, where's the light, that, you see that? Uh, I think sort of calf, back of my calf, because I didn't notice it, my wife noticed it actually. Um, probably, uh, around the end of February, the middle to end of Feb. And then it, like, it didn't actually cause too much itching, or anything, at the time. And, I, it faded over a couple of weeks, I guess. Um, I, to be honest that actually turns out it was a bit of a sore throat I had, um, so possibly a little bit feverish, but I, I sort of put it down to that. Uh, I like, I do quite a lot of walking, and we did, um, quite a lot while we were out in the, on holiday as well, but definitely, um. Yeah, I mean, I don't, I don't recall any bugs, I don't remember seeing anything bitten but you often, like, yeah, as you're walking through, I was in shorts and, and boots but / Um, just sort of, um, he examined me, so. Um, no. But it's the sort of headache maybe in just generally feeling a bit crappy. Um, I've been going to work. I don't know how effective it's been. But, yeah, been, been. Um, I work for a health technology company actually. Yeah, definitely sort of tired and, um, yeah, less energy, sort of probably than I, I would normally be. Um. Not as much. I, I don't know if it's, I haven't been able to or I've just been a bit lazy with it. I I'm not exercising as I would normally. Hey. Pretty good at the moment, actually. Like, it previously that has been an issue, but, um. Other than, sort of, physically feeling a bit. Uh, crappy, I've. Yeah, in a pretty good place. Uh, yeah, sort of aching shoulders, back, the hips, knees, but sort of, yeah. Not , No, . Uh, no. Uh, I mean. Asthma and hay fever if they can help. Uh, no, pretty well , I think. Uh, yeah. I've got one of those, um, preventative, I think. Yeah , but I've not used one. I, I have it. I've been using the everyday for the morning and night but not the, uh, . Um, I take, um, one of the antihistamines it might be can I get that from, just from the pharmacy. uh, . Sorry, occasionally, that was. Uh, just my wife. Uh, yeah, I but, uh, what, what's the infection? OK. OK. OK. OK, so, do the test first and then, and that follow up we can just do over the phone again? Or, yeah. All right. Excellent. That, that's really helpful, thank you very much. Oops, sorry, you broke up a bit there. Ohh, no, not , no. OK, take care, thank you, bye.",
"num_turns": 107,
"reference_note": "{\"day\": 5, \"consultation\": 9, \"presenting_complaint\": \"Tired all the time\", \"note\": \"PC: Tired all the time.\\n\\nHPC: Tired and feeling run down for last 6 weeks. Last felt well at xmas. Seemed to start after return from holiday in the States. Did lots of walking in shorts in Yosemite, didn't notice bite. Well when on hol. Felt unwell on return. Initially had red circular rash on back of calf mid-end Feb. Lasted few weeks and faded. Had fever, sore throat at that time. Reduced appetite, no wt loss, \\n\\nSE: GI - Dec app, no change in BH, no blood in stool, no dyspepsia.\\nNeuro: General headache/no visual disturbance/altered sens/weakness.Yosemite Park. \\nRS: No cough/sputum/CP/SOB. No coryzal sx/sore throat.\\nNot exercising due to lack of energy\\nLS: Aching shoulder/legs/back. No joint swelling.\\nNo other rashes noted.\\n\\nNo sx depression.\\n\\nPMH: Asthma, hayfever\\n\\nDH: Has bd inhaler ? ICS, does not take salbutamol regularly. Cetirizine OD\\nOcc.Lives with wife. Non smoker. Occ alcohol.\\n\\nImp: 6/52 hx fatigue and hx circular rash on calf.\\n\\nPlan: Needs screening bloods for TATT including Lyme serology.\\n\\nFU 1 week later with GP.\\n10. 13:30-13:50\\n\\t\\t\\u201cI have a blinding headache\\u201d\\nNote: PC : Headache\\n\\nHPC: 3/7 hx headache. Starts on waking up. Over right eye. Seeing lights in front of eyes. Can be worse when stands up not when bends over/cough/sneeze. Vision not disturbed. No nausea/vomiting. No altered taste/smell. Worse in the light. No rash. No fever. No coryzal symptoms. Not woken up in the night. No tingling/numbness/weakness. \\nWell before this episode. Has been lacking in energy but no wt loss. \\nSeverity 5-8/10. Taking ibuprofen, eases slightly but not resolving. \\n\\nHas had some generalised headaches before but not bad and associated symptoms/altered vision.\\nPMH: Nil\\nDH: Mercilon. BP last checked 1 yr ago was normal.\\n\\nFMHx: Mum has migraine.\\n\\nSH: Non smoker. No illicit drugs, 3 beers/week. Works from home.\\n\\nImp: Likely migraine but as ongoing and persistent needs neurological examination to exclude other pathology. Advised regular paracetamol and naproxen with food (will prescribe). If gets worse in meantime contact us straightaway or go to A&E is severe/unrelenting.\\n\", \"highlights\": [\"Tired\", \"Did lots of walking in shorts in Yosemite\", \"red circular rash\", \"fever\", \"sore throat\", \"Aching shoulder/legs/back\"]}",
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"consultation_id": "day5_consultation10",
"dialogue": "[Doctor] Hi there. It's Doctor Smith from Babylon.\n[Doctor] Can you confirm your name, date of birth, and your home address, please?\n[Patient] Um, it's . \n[Doctor] . Um, I can't hear you at the moment actually. Could you turn it up, the, volume up?\n[Patient] Uh, can you hear me better now?\n[Doctor] . Yeah, that's better. Thank you.\n[Patient] Um, OK. Sorry about that.\n[Doctor] Are you in a private place you can have a consultation?\n[Patient] Uh, yes.\n[Doctor] What can I do for you today?\n[Patient] Um, I've been having this, blinding headache for a few days. Um, and it's like, really bothering me and , I find it very hard to focus or, like I can't even go to work.\n[Doctor] OK, and any headaches in the past before this?\n[Patient] Not really just they're, on and off. Um, I recently had a, a one for like two days, um, but it just went away with Ibuprofen, so nothing like, more, longer than two days before.\n[Doctor] So, how did this start?\n[Patient] Um, it just started all of a sudden. I woke up one morning with a headache, and that was three days ago, and I just keep having it. Doesn't really go away with Ibuprofen either, I try that, but it just. It gets a little bit better but like, doesn't go away.\n[Doctor] OK, and whereabouts in your head is the pain?\n[Patient] Um, it's kind of all over but, I feel like over my right eye, it's um bit, stronger.\n[Doctor] OK. Any problems with your vision? Or, any problems tolerating the light?\n[Patient] Um, lights definitely make me more sensitive. Like, um, I don't really, like strong lights. Um, and um, yeah, vision I think, I get this, shooting light sometimes. Um, not sure how to explain it. Just a bit of um, weird kind of vision.\n[Doctor] OK, and um, any, any nausea or vomiting?\n[Patient] Uh, no, feeling a bit sick, but no vomiting.\n[Doctor] Any tingling? Or numbness? Or weakness anywhere?\n[Patient] Um, no.\n[Doctor] Any change in your smell or taste?\n[Patient] No, none at all.\n[Doctor] Um, and, in the past, when you've had headaches, what have they been like?\n[Patient] Um, I was sick but I had no more headache, it's just um, a bit of a pressure, in between my eyes, um. But nothing major.\n[Doctor] OK, and, with, with this, has it been there all the time? Or is it coming and going?\n[Patient] Kinda all the time. Um, so when I take Ibuprofen it gets a bit better, so it's a bit, like less um, it, it bothered me less, but then I still have it, it's still there.\n[Doctor] Um, and what would you say, the severity is? If, if ten is the worst pain you've ever had, and zero is nothing, what would you say the pain is like?\n[Patient] I guess it's mostly, eight, and then it kinda comes down to maybe a five.\n[Doctor] OK, and what about at night-time, are you able to fall asleep?\n[Patient] Um, yeah, I'm, sleeping well.\n[Doctor] Is it waking you up in the night-time?\n[Patient] No, no, no. But I can wake up with it in the morning.\n[Doctor] OK. Any worse when you change position, or bend over, or cough, or anything like that?\n[Patient] Mmm. Sometimes when I stand up, quickly I get a bit of a, stabbing pain. Um, or if I throw my head like, it I kind of feel like something is moving inside.\n[Doctor] OK. And have you had any, uh, eye checks recently?\n[Patient] Um, yeah, actually had one recently and, nothing changed my vision.\n[Doctor] OK. And have you had any cold symptoms, sore throat, sore ears, or pain over the sinuses? Any cough or flem?\n[Patient] No, no. \n[Doctor] No. Any, any nose bleeds, or coughing up any blood or anything?\n[Patient] No.\n[Doctor] And just recently, have you been well, or have you had any general problems? Any change in your weight? Or, tiredness, lack of energy, anything like that?\n[Patient] Um, no change of weight, maybe um, lack of energy but it might be because, I'm just having these headaches. so I'm find it quite difficult to go through my daily activities , you know when you have this constant headache.\n[Doctor] Have you been at work recently?\n[Patient] Um, I work from home but, couldn't really manage to, do it all the time. So sometimes I just took a day off.\n[Doctor] So, you've been, you've had a headache for three days. , how many days have you missed off work?\n[Patient] Um, so I worked from home all these three days and, um. First day I worked from home and then, um, the second I just took the whole day off. And, today I just tried to work from home the first half of the day but, I, I just stopped in the morning 'cause, I couldn't focus.\n[Doctor] OK. And, any other, medical problems in the past?\n[Patient] Um, I think I only had a, a pain, um, when I was younger but, no causes found and that went away, but that's, the only thing I know of.\n[Doctor] \n[Doctor] OK. Have you been abroad recently at all?\n[Patient] No.\n[Doctor] Do you take any medications?\n[Patient] Um, just the pill.\n[Doctor] Which one?\n[Patient] Um, .\n[Doctor] And when did you start that?\n[Patient] Um, about a year ago.\n[Doctor] Any side effects with that?\n[Patient] Uh, no I don't think so.\n[Doctor] Have you noticed any, any um, increased frequency of headaches since you started that?\n[Patient] Um, no, , these headaches just very recently, but nothing um, but nothing really changes.\n[Doctor] \n[Doctor] OK. And when you'd , when you've had, when you described your headaches in the past, you said they were just general. Did you have any visual symptoms? Flashing lights? Nausea, vomiting with them?\n[Patient] No. No, no.\n[Patient] No nothing, none of those.\n[Doctor] Have you had your blood pressure checked recently with your pill?\n[Patient] Um, yeah, I had it checked in the pharmacy when I got the pill, and they say it was normal.\n[Doctor] And when was that?\n[Patient] Uh, a year ago.\n[Doctor] OK. Um, and any allergies to anything?\n[Patient] No.\n[Doctor] And who do you live with at home?\n[Patient] Sorry?\n[Doctor] Who do you live with at home?\n[Patient] Uh, just by myself.\n[Doctor] OK. And do you smoke?\n[Patient] Uh, no.\n[Doctor] Do you drink any alcohol regularly?\n[Patient] Yeah.\n[Doctor] How much in a normal week do you think?\n[Patient] Um, probably like, three , once a week.\n[Doctor] . OK. And do you take any other drugs at all?\n[Patient] Um, no apart from the Ibuprofen that I take, sometimes when, the headache gets really bad, nothing else.\n[Doctor] OK. Um. So, uh, I mean it's obviously the first time you've had such a bad headache. And you said you'd had some altered light in front of your eyes as well?\n[Patient] Yeah.\n[Doctor] But you haven't had a high temperature. Have you checked your temperature?\n[Patient] Uh, no I didn't, I don't really feel, feverish or anything.\n[Doctor] OK. Um, I mean it, it, it could possibly be a migraine type headache. But, the fact it's still ongoing for three days, we probably should, book you into an appointment to get an examination.\n[Patient] \n[Doctor] Um, obviously , if it settles, in the meantime then, we can cancel that. But we should do a neurological examination, look at the back of your eyes as well.\n[Patient] OK.\n[Doctor] Um, in terms of medication, I can prescribe you something, similar to Ibuprofen, but a bit stronger which you can take instead of Ibuprofen. And you can also take Paracetamol at the same time.\n[Patient] \n[Patient] OK.\n[Doctor] So if you're happy to book a, , appointment with us, with the support line, for us to do a full examination. And start, the medication which I prescribe to you, take it with food. If, if you're, you said that when you go to bed your headache's, OK, and not waking you up in the night-time.\n[Patient] Yeah it's not, um but, you mentioned migraine and that um, reminded that, my mum, suffers from, like she has migraines, um.\n[Doctor] OK. Any other family history of medical problems?\n[Patient] Um, no I think that's it, but I know that my mum like, she has quite bad migraines, she's like, has the vomiting and everything, .\n[Doctor] OK that's fine. Um, I mean if, if in the meantime before your appointment your, headache is getting unbearable, getting worse or changing. Then , um, if it's that bad, then you should go to A and E and have an examination. Um, , you can call us for further advice on that.\n[Patient] OK.\n[Patient] Mm-hmm, OK.\n[Doctor] And when, when you have a, an examination with us, we'll check your blood pressure as well. Just to, make sure your pill's still appropriate for you, because sometimes if we, if we do think it's a migraine, then you would have to change your pill. If you've had these flashing lights, and things like that.\n[Patient] \n[Patient] OK, .\n[Patient] Is there anything in the pill that can cause it? Or is it?\n[Doctor] Well , some , so that pill if you were having , regular migraines with um, flashing lights, or , other symptoms. It wouldn't be suitable to stay on that pill, particularly, we'd have to change it to something else.\n[Patient] All right.\n[Doctor] But you can carry on with that for the moment.\n[Patient] OK.\n[Doctor] Have you got any other questions?\n[Patient] Um, so will you like, um, send me a referral to a specialist, or do I have to to confirm?\n[Doctor] Uh. Yeah, if you book an appointment with the support team, then we can do a full examination then.\n[Patient] OK. Perfect.\n[Doctor] All right then. Take care.\n[Patient] Thank you very much.\n[Doctor] Bye.",
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"text": "OK. Any problems with your vision? Or, any problems tolerating the light?",
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"text": "Um, so I worked from home all these three days and, um. First day I worked from home and then, um, the second I just took the whole day off. And, today I just tried to work from home the first half of the day but, I, I just stopped in the morning 'cause, I couldn't focus.",
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"text": "Um, I think I only had a, a pain, um, when I was younger but, no causes found and that went away, but that's, the only thing I know of.",
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"speaker": "Patient"
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"speaker": "Patient"
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"text": "And when did you start that?",
"speaker": "Doctor"
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"speaker": "Patient"
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"text": "Any side effects with that?",
"speaker": "Doctor"
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"text": "Uh, no I don't think so.",
"speaker": "Patient"
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"text": "Have you noticed any, any um, increased frequency of headaches since you started that?",
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"text": "Um, no, , these headaches just very recently, but nothing um, but nothing really changes.",
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"text": "OK. And when you'd , when you've had, when you described your headaches in the past, you said they were just general. Did you have any visual symptoms? Flashing lights? Nausea, vomiting with them?",
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"text": "No. No, no.",
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"text": "No nothing, none of those.",
"speaker": "Patient"
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"text": "Have you had your blood pressure checked recently with your pill?",
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"text": "Um, yeah, I had it checked in the pharmacy when I got the pill, and they say it was normal.",
"speaker": "Patient"
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{
"start": 375.85572,
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"text": "And when was that?",
"speaker": "Doctor"
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{
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"text": "Uh, a year ago.",
"speaker": "Patient"
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{
"start": 378.71286,
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"text": "OK. Um, and any allergies to anything?",
"speaker": "Doctor"
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{
"start": 382.8891,
"end": 383.60239,
"text": "No.",
"speaker": "Patient"
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{
"start": 384.23164,
"end": 386.18653,
"text": "And who do you live with at home?",
"speaker": "Doctor"
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{
"start": 386.44881,
"end": 387.2513,
"text": "Sorry?",
"speaker": "Patient"
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{
"start": 387.11134,
"end": 388.66773,
"text": "Who do you live with at home?",
"speaker": "Doctor"
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{
"start": 388.58562,
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"text": "Uh, just by myself.",
"speaker": "Patient"
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{
"start": 390.26171,
"end": 392.56245,
"text": "OK. And do you smoke?",
"speaker": "Doctor"
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{
"start": 392.73998,
"end": 393.49472,
"text": "Uh, no.",
"speaker": "Patient"
},
{
"start": 393.84817,
"end": 395.96094,
"text": "Do you drink any alcohol regularly?",
"speaker": "Doctor"
},
{
"start": 395.8825,
"end": 396.48931,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 396.87072,
"end": 398.9835,
"text": "How much in a normal week do you think?",
"speaker": "Doctor"
},
{
"start": 399.29353,
"end": 403.71019,
"text": "Um, probably like, three , once a week.",
"speaker": "Patient"
},
{
"start": 401.96845,
"end": 407.7579,
"text": ". OK. And do you take any other drugs at all?",
"speaker": "Doctor"
},
{
"start": 408.18574,
"end": 415.37328,
"text": "Um, no apart from the Ibuprofen that I take, sometimes when, the headache gets really bad, nothing else.",
"speaker": "Patient"
},
{
"start": 414.58494,
"end": 425.77979,
"text": "OK. Um. So, uh, I mean it's obviously the first time you've had such a bad headache. And you said you'd had some altered light in front of your eyes as well?",
"speaker": "Doctor"
},
{
"start": 425.91009,
"end": 426.72035,
"text": "Yeah.",
"speaker": "Patient"
},
{
"start": 426.56331,
"end": 429.70991,
"text": "But you haven't had a high temperature. Have you checked your temperature?",
"speaker": "Doctor"
},
{
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"end": 435.25486,
"text": "Uh, no I didn't, I don't really feel, feverish or anything.",
"speaker": "Patient"
},
{
"start": 435.42503,
"end": 448.65999,
"text": "OK. Um, I mean it, it, it could possibly be a migraine type headache. But, the fact it's still ongoing for three days, we probably should, book you into an appointment to get an examination.",
"speaker": "Doctor"
},
{
"start": 441.47992,
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"text": "",
"speaker": "Patient"
},
{
"start": 448.65999,
"end": 457.0359,
"text": "Um, obviously , if it settles, in the meantime then, we can cancel that. But we should do a neurological examination, look at the back of your eyes as well.",
"speaker": "Doctor"
},
{
"start": 457.19252,
"end": 458.05606,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 458.44191,
"end": 470.43434,
"text": "Um, in terms of medication, I can prescribe you something, similar to Ibuprofen, but a bit stronger which you can take instead of Ibuprofen. And you can also take Paracetamol at the same time.",
"speaker": "Doctor"
},
{
"start": 467.79255,
"end": 468.56079,
"text": "",
"speaker": "Patient"
},
{
"start": 470.63159,
"end": 471.51328,
"text": "OK.",
"speaker": "Patient"
},
{
"start": 471.86291,
"end": 490.50194,
"text": "So if you're happy to book a, , appointment with us, with the support line, for us to do a full examination. And start, the medication which I prescribe to you, take it with food. If, if you're, you said that when you go to bed your headache's, OK, and not waking you up in the night-time.",
"speaker": "Doctor"
},
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"text": "Yeah it's not, um but, you mentioned migraine and that um, reminded that, my mum, suffers from, like she has migraines, um.",
"speaker": "Patient"
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"text": "OK. Any other family history of medical problems?",
"speaker": "Doctor"
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"text": "Um, no I think that's it, but I know that my mum like, she has quite bad migraines, she's like, has the vomiting and everything, .",
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"text": "OK that's fine. Um, I mean if, if in the meantime before your appointment your, headache is getting unbearable, getting worse or changing. Then , um, if it's that bad, then you should go to A and E and have an examination. Um, , you can call us for further advice on that.",
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"text": "OK.",
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"text": "Mm-hmm, OK.",
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"text": "And when, when you have a, an examination with us, we'll check your blood pressure as well. Just to, make sure your pill's still appropriate for you, because sometimes if we, if we do think it's a migraine, then you would have to change your pill. If you've had these flashing lights, and things like that.",
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"text": "Is there anything in the pill that can cause it? Or is it?",
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"text": "Well , some , so that pill if you were having , regular migraines with um, flashing lights, or , other symptoms. It wouldn't be suitable to stay on that pill, particularly, we'd have to change it to something else.",
"speaker": "Doctor"
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{
"start": 561.052,
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"text": "All right.",
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"text": "But you can carry on with that for the moment.",
"speaker": "Doctor"
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"text": "OK.",
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"text": "Have you got any other questions?",
"speaker": "Doctor"
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"text": "Um, so will you like, um, send me a referral to a specialist, or do I have to to confirm?",
"speaker": "Patient"
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{
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"text": "Uh. Yeah, if you book an appointment with the support team, then we can do a full examination then.",
"speaker": "Doctor"
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"start": 580.28087,
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"text": "OK. Perfect.",
"speaker": "Patient"
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{
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"text": "All right then. Take care.",
"speaker": "Doctor"
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"text": "Thank you very much.",
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"doctor_utterances": "Hi there. It's Doctor Smith from Babylon. Can you confirm your name, date of birth, and your home address, please? . Um, I can't hear you at the moment actually. Could you turn it up, the, volume up? . Yeah, that's better. Thank you. Are you in a private place you can have a consultation? What can I do for you today? OK, and any headaches in the past before this? So, how did this start? OK, and whereabouts in your head is the pain? OK. Any problems with your vision? Or, any problems tolerating the light? OK, and um, any, any nausea or vomiting? Any tingling? Or numbness? Or weakness anywhere? Any change in your smell or taste? Um, and, in the past, when you've had headaches, what have they been like? OK, and, with, with this, has it been there all the time? Or is it coming and going? Um, and what would you say, the severity is? If, if ten is the worst pain you've ever had, and zero is nothing, what would you say the pain is like? OK, and what about at night-time, are you able to fall asleep? Is it waking you up in the night-time? OK. Any worse when you change position, or bend over, or cough, or anything like that? OK. And have you had any, uh, eye checks recently? OK. And have you had any cold symptoms, sore throat, sore ears, or pain over the sinuses? Any cough or flem? No. Any, any nose bleeds, or coughing up any blood or anything? And just recently, have you been well, or have you had any general problems? Any change in your weight? Or, tiredness, lack of energy, anything like that? Have you been at work recently? So, you've been, you've had a headache for three days. , how many days have you missed off work? OK. And, any other, medical problems in the past? OK. Have you been abroad recently at all? Do you take any medications? Which one? And when did you start that? Any side effects with that? Have you noticed any, any um, increased frequency of headaches since you started that? OK. And when you'd , when you've had, when you described your headaches in the past, you said they were just general. Did you have any visual symptoms? Flashing lights? Nausea, vomiting with them? Have you had your blood pressure checked recently with your pill? And when was that? OK. Um, and any allergies to anything? And who do you live with at home? Who do you live with at home? OK. And do you smoke? Do you drink any alcohol regularly? How much in a normal week do you think? . OK. And do you take any other drugs at all? OK. Um. So, uh, I mean it's obviously the first time you've had such a bad headache. And you said you'd had some altered light in front of your eyes as well? But you haven't had a high temperature. Have you checked your temperature? OK. Um, I mean it, it, it could possibly be a migraine type headache. But, the fact it's still ongoing for three days, we probably should, book you into an appointment to get an examination. Um, obviously , if it settles, in the meantime then, we can cancel that. But we should do a neurological examination, look at the back of your eyes as well. Um, in terms of medication, I can prescribe you something, similar to Ibuprofen, but a bit stronger which you can take instead of Ibuprofen. And you can also take Paracetamol at the same time. So if you're happy to book a, , appointment with us, with the support line, for us to do a full examination. And start, the medication which I prescribe to you, take it with food. If, if you're, you said that when you go to bed your headache's, OK, and not waking you up in the night-time. OK. Any other family history of medical problems? OK that's fine. Um, I mean if, if in the meantime before your appointment your, headache is getting unbearable, getting worse or changing. Then , um, if it's that bad, then you should go to A and E and have an examination. Um, , you can call us for further advice on that. And when, when you have a, an examination with us, we'll check your blood pressure as well. Just to, make sure your pill's still appropriate for you, because sometimes if we, if we do think it's a migraine, then you would have to change your pill. If you've had these flashing lights, and things like that. Well , some , so that pill if you were having , regular migraines with um, flashing lights, or , other symptoms. It wouldn't be suitable to stay on that pill, particularly, we'd have to change it to something else. But you can carry on with that for the moment. Have you got any other questions? Uh. Yeah, if you book an appointment with the support team, then we can do a full examination then. All right then. Take care. Bye.",
"patient_utterances": "Um, it's . Uh, can you hear me better now? Um, OK. Sorry about that. Uh, yes. Um, I've been having this, blinding headache for a few days. Um, and it's like, really bothering me and , I find it very hard to focus or, like I can't even go to work. Not really just they're, on and off. Um, I recently had a, a one for like two days, um, but it just went away with Ibuprofen, so nothing like, more, longer than two days before. Um, it just started all of a sudden. I woke up one morning with a headache, and that was three days ago, and I just keep having it. Doesn't really go away with Ibuprofen either, I try that, but it just. It gets a little bit better but like, doesn't go away. Um, it's kind of all over but, I feel like over my right eye, it's um bit, stronger. Um, lights definitely make me more sensitive. Like, um, I don't really, like strong lights. Um, and um, yeah, vision I think, I get this, shooting light sometimes. Um, not sure how to explain it. Just a bit of um, weird kind of vision. Uh, no, feeling a bit sick, but no vomiting. Um, no. No, none at all. Um, I was sick but I had no more headache, it's just um, a bit of a pressure, in between my eyes, um. But nothing major. Kinda all the time. Um, so when I take Ibuprofen it gets a bit better, so it's a bit, like less um, it, it bothered me less, but then I still have it, it's still there. I guess it's mostly, eight, and then it kinda comes down to maybe a five. Um, yeah, I'm, sleeping well. No, no, no. But I can wake up with it in the morning. Mmm. Sometimes when I stand up, quickly I get a bit of a, stabbing pain. Um, or if I throw my head like, it I kind of feel like something is moving inside. Um, yeah, actually had one recently and, nothing changed my vision. No, no. No. Um, no change of weight, maybe um, lack of energy but it might be because, I'm just having these headaches. so I'm find it quite difficult to go through my daily activities , you know when you have this constant headache. Um, I work from home but, couldn't really manage to, do it all the time. So sometimes I just took a day off. Um, so I worked from home all these three days and, um. First day I worked from home and then, um, the second I just took the whole day off. And, today I just tried to work from home the first half of the day but, I, I just stopped in the morning 'cause, I couldn't focus. Um, I think I only had a, a pain, um, when I was younger but, no causes found and that went away, but that's, the only thing I know of. No. Um, just the pill. Um, . Um, about a year ago. Uh, no I don't think so. Um, no, , these headaches just very recently, but nothing um, but nothing really changes. No. No, no. No nothing, none of those. Um, yeah, I had it checked in the pharmacy when I got the pill, and they say it was normal. Uh, a year ago. No. Sorry? Uh, just by myself. Uh, no. Yeah. Um, probably like, three , once a week. Um, no apart from the Ibuprofen that I take, sometimes when, the headache gets really bad, nothing else. Yeah. Uh, no I didn't, I don't really feel, feverish or anything. OK. OK. Yeah it's not, um but, you mentioned migraine and that um, reminded that, my mum, suffers from, like she has migraines, um. Um, no I think that's it, but I know that my mum like, she has quite bad migraines, she's like, has the vomiting and everything, . OK. Mm-hmm, OK. OK, . Is there anything in the pill that can cause it? Or is it? All right. OK. Um, so will you like, um, send me a referral to a specialist, or do I have to to confirm? OK. Perfect. Thank you very much.",
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"dialogue": "[Patient] Hi.\n[Doctor] Hi there. It's Doctor Smith from Babylon.\n[Patient] Hey. How are you?\n[Doctor] How are you doing? . Good thank you. Can you confirm your name, date of birth, and your, home address please?\n[Patient] Um, yes I can. Uh, it's, Mary Smith.\n[Doctor] \n[Patient] Um, I'm twenty eight, and I live at apartment four oh five, nine C, Clerkenwell Road.\n[Doctor] OK that's fine. Are you in a private place so you can have a consultation today?\n[Patient] Yes I am.\n[Doctor] What can I do for you?\n[Patient] Um, I keep having a headache.\n[Doctor] OK, and when did it start?\n[Patient] It started yesterday, um. Uh, it's unusual for me, to have a headache.\n[Doctor] OK. Can you just tell me whereabouts in your head it is?\n[Patient] It's on the left side at the back, sort of here.\n[Doctor] . OK. Just on the left side.\n[Patient] Yes.\n[Doctor] And, when did it start? What time of day did it start yesterday?\n[Patient] About mid-morning.\n[Doctor] And how did it feel when it first started?\n[Patient] Um, just quite, intense, and kinda quite throbbing. It kind of built up gradually after, over. A short period of time.\n[Doctor] OK. And did you get uh, have you got any other symptoms along with that? Any nausea, vomiting, tingling, numbness, weakness, anywhere?\n[Patient] No, nothing.\n[Doctor] OK, and, uh. Sorry . Um, any blurred vision, or any pain over your eyes?\n[Patient] Um. No.\n[Doctor] Any , any funny lights or, anything like that in your vision area? Any problems when you look into the light?\n[Patient] No, .\n[Patient] No.\n[Doctor] Um, and have you been eating and drinking OK?\n[Patient] Yes, yes, like normal.\n[Doctor] . Are you feeling sick, or vomiting, or anything?\n[Patient] No, nothing like that, .\n[Doctor] Any high fevers? Are you feeling shivery? Sweaty?\n[Patient] No, no fever, no .\n[Doctor] Any , any rashes at all?\n[Patient] No.\n[Doctor] And, in the past, have you had any headache before?\n[Patient] Not really.\n[Doctor] OK. How bad would you say the headache is from, zero to ten, if ten is the worst pain that you could have, and zero is nothing?\n[Patient] I'd say about eight.\n[Doctor] OK. And have you taken any pain killers?\n[Patient] Um, I took some, um, um, Nurofen, yesterday.\n[Doctor] OK, and did that make any difference?\n[Patient] Not really.\n[Doctor] And last night, did you manage to sleep through the night OK?\n[Patient] Uh, yes I did.\n[Doctor] Has it been worse at any particular time of the day?\n[Patient] No, it hasn't made any difference, the time of the day.\n[Doctor] Any difference if you lie down, stand up, bend over, cough or sneeze, or anything like that?\n[Patient] Um, no.\n[Doctor] And, have you got any other medical problems?\n[Patient] Um, no I haven't.\n[Doctor] Anything you take medication for?\n[Patient] No I don't.\n[Doctor] Um, any over-the-counter medications or allergies?\n[Patient] No, only the, Nurofen I took yesterday, Ibuprofen.\n[Doctor] That's fine. And any stomach problems, or asthma at all?\n[Patient] No.\n[Doctor] Anyone in your family got any medical problems?\n[Patient] Uh, my mother's had hypertension, and she does get migraines.\n[Doctor] . And, have you had your blood pressure checked ?\n[Patient] Um, no, not recently.\n[Doctor] And who do you live with at home?\n[Patient] Sorry?\n[Doctor] Who do you live with at home?\n[Patient] My partner.\n[Doctor] And what's your job, day-to-day?\n[Patient] I'm a designer.\n[Doctor] Have you had to miss any work at all?\n[Patient] Uh, no, but I don't feel that, I'm finding it really hard to , to do any of, my work, or, normal things.\n[Doctor] OK. Um, and do you smoke at all normally?\n[Patient] No I don't.\n[Doctor] Do you drink any alcohol regularly?\n[Patient] No.\n[Doctor] Um, and any other drugs?\n[Patient] No.\n[Doctor] No, OK. Um, I mean the fact that you haven't had headaches before, um, is, is unusual the fact that they've developed. Is there anything you think's changed? Any increased stress, , change in your diet or lifestyle?\n[Patient] Not that I can, not that I can think of.\n[Doctor] OK. So, what we would suggest is, trying a slightly stronger, pain relief. Uh, so, similar to Ibuprofen, but taking instead of Ibuprofen not at the same time, and taking that regularly with food.\n[Patient] OK.\n[Doctor] Um, hopefully that will settle it down. You can take Paracetamol along with that.\n[Patient] Yes.\n[Doctor] Try and um, take rest, have lots of good hydration.Um, but if the pain's getting worse, or you get new symptoms, fever, rash, vomiting, neck stiffness. Um, or you keep getting episodes of the same type of thing, then we need to speak to you, and, and make a plan for, for what we can do next.\n[Patient] OK. Thank you.\n[Doctor] Have you got any other questions?\n[Patient] How long do you think it will last for?\n[Doctor] Well I should think it should down, if it's getting worse or not settling in the next day or two. Then certainly give us a call back, if, when you've tried the medication that I've prescribed from the pharmacy.\n[Patient] \n[Patient] OK.\n[Doctor] OK?\n[Patient] Thank you.\n[Doctor] All right then. Thanks a lot. Bye.\n[Patient] , bye.",
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"text": "No, it hasn't made any difference, the time of the day.",
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{
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"text": "Any difference if you lie down, stand up, bend over, cough or sneeze, or anything like that?",
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"text": "Um, no.",
"speaker": "Patient"
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{
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"text": "And, have you got any other medical problems?",
"speaker": "Doctor"
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{
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"text": "Um, no I haven't.",
"speaker": "Patient"
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{
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"text": "Anything you take medication for?",
"speaker": "Doctor"
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{
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"text": "No I don't.",
"speaker": "Patient"
},
{
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"text": "Um, any over-the-counter medications or allergies?",
"speaker": "Doctor"
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{
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"text": "No, only the, Nurofen I took yesterday, Ibuprofen.",
"speaker": "Patient"
},
{
"start": 189.03154,
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"text": "That's fine. And any stomach problems, or asthma at all?",
"speaker": "Doctor"
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{
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"text": "No.",
"speaker": "Patient"
},
{
"start": 192.7887,
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"text": "Anyone in your family got any medical problems?",
"speaker": "Doctor"
},
{
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"text": "Uh, my mother's had hypertension, and she does get migraines.",
"speaker": "Patient"
},
{
"start": 200.52786,
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"text": ". And, have you had your blood pressure checked ?",
"speaker": "Doctor"
},
{
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"text": "Um, no, not recently.",
"speaker": "Patient"
},
{
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"text": "And who do you live with at home?",
"speaker": "Doctor"
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{
"start": 209.42191,
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"text": "Sorry?",
"speaker": "Patient"
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{
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"text": "Who do you live with at home?",
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"text": "My partner.",
"speaker": "Patient"
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{
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"text": "And what's your job, day-to-day?",
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"text": "I'm a designer.",
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{
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"text": "Have you had to miss any work at all?",
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{
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"text": "Uh, no, but I don't feel that, I'm finding it really hard to , to do any of, my work, or, normal things.",
"speaker": "Patient"
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{
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"text": "OK. Um, and do you smoke at all normally?",
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{
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"text": "No I don't.",
"speaker": "Patient"
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"text": "No.",
"speaker": "Patient"
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"text": "Um, and any other drugs?",
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"speaker": "Patient"
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{
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"text": "No, OK. Um, I mean the fact that you haven't had headaches before, um, is, is unusual the fact that they've developed. Is there anything you think's changed? Any increased stress, , change in your diet or lifestyle?",
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},
{
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"text": "Not that I can, not that I can think of.",
"speaker": "Patient"
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{
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"text": "OK. So, what we would suggest is, trying a slightly stronger, pain relief. Uh, so, similar to Ibuprofen, but taking instead of Ibuprofen not at the same time, and taking that regularly with food.",
"speaker": "Doctor"
},
{
"start": 265.3804,
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"text": "OK.",
"speaker": "Patient"
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{
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"text": "Um, hopefully that will settle it down. You can take Paracetamol along with that.",
"speaker": "Doctor"
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{
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"text": "Yes.",
"speaker": "Patient"
},
{
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"text": "Try and um, take rest, have lots of good hydration.Um, but if the pain's getting worse, or you get new symptoms, fever, rash, vomiting, neck stiffness. Um, or you keep getting episodes of the same type of thing, then we need to speak to you, and, and make a plan for, for what we can do next.",
"speaker": "Doctor"
},
{
"start": 299.75054,
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"text": "OK. Thank you.",
"speaker": "Patient"
},
{
"start": 301.69414,
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"text": "Have you got any other questions?",
"speaker": "Doctor"
},
{
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"text": "How long do you think it will last for?",
"speaker": "Patient"
},
{
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"text": "Well I should think it should down, if it's getting worse or not settling in the next day or two. Then certainly give us a call back, if, when you've tried the medication that I've prescribed from the pharmacy.",
"speaker": "Doctor"
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{
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"speaker": "Patient"
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{
"start": 318.43135,
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"text": "OK.",
"speaker": "Patient"
},
{
"start": 319.82963,
"end": 320.82963,
"text": "OK?",
"speaker": "Doctor"
},
{
"start": 320.76749,
"end": 321.89354,
"text": "Thank you.",
"speaker": "Patient"
},
{
"start": 321.67174,
"end": 324.35597,
"text": "All right then. Thanks a lot. Bye.",
"speaker": "Doctor"
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{
"start": 322.78243,
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"text": ", bye.",
"speaker": "Patient"
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"doctor_utterances": "Hi there. It's Doctor Smith from Babylon. How are you doing? . Good thank you. Can you confirm your name, date of birth, and your, home address please? OK that's fine. Are you in a private place so you can have a consultation today? What can I do for you? OK, and when did it start? OK. Can you just tell me whereabouts in your head it is? . OK. Just on the left side. And, when did it start? What time of day did it start yesterday? And how did it feel when it first started? OK. And did you get uh, have you got any other symptoms along with that? Any nausea, vomiting, tingling, numbness, weakness, anywhere? OK, and, uh. Sorry . Um, any blurred vision, or any pain over your eyes? Any , any funny lights or, anything like that in your vision area? Any problems when you look into the light? Um, and have you been eating and drinking OK? . Are you feeling sick, or vomiting, or anything? Any high fevers? Are you feeling shivery? Sweaty? Any , any rashes at all? And, in the past, have you had any headache before? OK. How bad would you say the headache is from, zero to ten, if ten is the worst pain that you could have, and zero is nothing? OK. And have you taken any pain killers? OK, and did that make any difference? And last night, did you manage to sleep through the night OK? Has it been worse at any particular time of the day? Any difference if you lie down, stand up, bend over, cough or sneeze, or anything like that? And, have you got any other medical problems? Anything you take medication for? Um, any over-the-counter medications or allergies? That's fine. And any stomach problems, or asthma at all? Anyone in your family got any medical problems? . And, have you had your blood pressure checked ? And who do you live with at home? Who do you live with at home? And what's your job, day-to-day? Have you had to miss any work at all? OK. Um, and do you smoke at all normally? Do you drink any alcohol regularly? Um, and any other drugs? No, OK. Um, I mean the fact that you haven't had headaches before, um, is, is unusual the fact that they've developed. Is there anything you think's changed? Any increased stress, , change in your diet or lifestyle? OK. So, what we would suggest is, trying a slightly stronger, pain relief. Uh, so, similar to Ibuprofen, but taking instead of Ibuprofen not at the same time, and taking that regularly with food. Um, hopefully that will settle it down. You can take Paracetamol along with that. Try and um, take rest, have lots of good hydration.Um, but if the pain's getting worse, or you get new symptoms, fever, rash, vomiting, neck stiffness. Um, or you keep getting episodes of the same type of thing, then we need to speak to you, and, and make a plan for, for what we can do next. Have you got any other questions? Well I should think it should down, if it's getting worse or not settling in the next day or two. Then certainly give us a call back, if, when you've tried the medication that I've prescribed from the pharmacy. OK? All right then. Thanks a lot. Bye.",
"patient_utterances": "Hi. Hey. How are you? Um, yes I can. Uh, it's, Mary Smith. Um, I'm twenty eight, and I live at apartment four oh five, nine C, Clerkenwell Road. Yes I am. Um, I keep having a headache. It started yesterday, um. Uh, it's unusual for me, to have a headache. It's on the left side at the back, sort of here. Yes. About mid-morning. Um, just quite, intense, and kinda quite throbbing. It kind of built up gradually after, over. A short period of time. No, nothing. Um. No. No, . No. Yes, yes, like normal. No, nothing like that, . No, no fever, no . No. Not really. I'd say about eight. Um, I took some, um, um, Nurofen, yesterday. Not really. Uh, yes I did. No, it hasn't made any difference, the time of the day. Um, no. Um, no I haven't. No I don't. No, only the, Nurofen I took yesterday, Ibuprofen. No. Uh, my mother's had hypertension, and she does get migraines. Um, no, not recently. Sorry? My partner. I'm a designer. Uh, no, but I don't feel that, I'm finding it really hard to , to do any of, my work, or, normal things. No I don't. No. No. Not that I can, not that I can think of. OK. Yes. OK. Thank you. How long do you think it will last for? OK. Thank you. , bye.",
"num_turns": 93,
"reference_note": "{\"day\": 5, \"consultation\": 12, \"presenting_complaint\": \"Headache\", \"note\": \"PC: Headache\\n\\nHPC L sided posterior headache. Started mid morning. 8/10 severity. No visual disturbance/visual floaters/tingling/numbness/weakness/nausea/vomiting/fever/neck stiffness. \\nNo worse cough/sneeze/bending. Did not wake her up in the night, slept ok . E&D fine. Finding it hard to concentrate on work.\\n\\nNo headaches in the past. \\nNo change in diet/liestyle/increased stress.\\n\\nDH: Nil\\n\\nFMH: Mother hypertension\\n\\nSH: Lives with partner. Designer. \\n\\nImp: New onset headache.\\n\\nPlan: Advised prescribed naproxen to take instead of ibuprofen. Can take alongside paracetmol. If pain not settling/worse or new symptoms to contact dr asap. If recurring episodes of same to have further assessment with GP.\\n\", \"highlights\": [\"\"]}",
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