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Transcript
 | Hi Dr. Douglas, My name is Danielle. I will be your provider today | Greet 03/25/20 12:48 AM CDT |
| Hello. | ||
| What is the reason for you visit today? | Question 03/25/20 12:48 AM CDT |
| I’m here because I’ve got an awful cough, a fever, and my chest feels like I’ve been kicked by a horse. I’m sure this is some kind of upper respiratory infection. I was hoping it would go away on its own, but it hasn’t, so my husband Jeffrey convinced me to come in. As amusing as it is for Jeffrey to serve me my meals, this has gone on long enough. I need to feel better. | ||
| I’m sorry to hear that you are so uncomfortable from your symptoms. Your frequent cough sounds like it’s aggravating your already uncomfortable chest pain. You have done a great job toughing it out so far, and we’ll find a treatment plan to help you feel better. | Empathize 03/25/20 12:52 AM CDT |
| Thank you. | ||
| When did your symptoms start? | Question 03/25/20 12:53 AM CDT |
| Most of my symptoms started three days ago. I developed this nasty cough, and my nose has been all stuffed up. That’s also when the chest pain started, and when I began to feel exhausted. The fever set in last night. That was the last straw, so Jeffrey brought me in. | ||
| How often do the symptoms occur? | Question 03/25/20 12:54 AM CDT |
| Most of my symptoms — the hacking cough, chest pain, fatigue, achiness, stuffy nose — started three days ago. The fever started yesterday. None of it has let up since. | ||
| Where is your pain? | Question 03/25/20 12:54 AM CDT |
| Most of the chest pain is located in the lower right part of my chest. Aside from that, I have some general aches and muscle soreness; this is mostly a deep, dull sort of ache, but it feels more severe when I cough. | ||
| I’m sorry to hear that you’re in constant pain, and that your cough makes your pain worse. I will work on finding a therapy that will give you some relief. | Empathize 03/25/20 12:56 AM CDT |
| I appreciate your saying that. | ||
| Are you coughing up any mucous? | Question 03/25/20 12:58 AM CDT |
| I’m coughing up rust-colored sputum. | ||
| Are there any factors that make your symptoms worse? (Clarified to Does anything make your symptoms worse?.) | Question 03/25/20 12:59 AM CDT |
| Coughing makes this chest pain much worse. Deep breathing also seems to aggravate it, or talking too much. I also can’t move around too much . . . I’ve been staying in bed because any kind of activity makes my pain worse and leaves me exhausted. (Clarified to if anything makes my symptoms worse.) | ||
| What helps relieve your symptoms | Question 03/25/20 1:00 AM CDT |
| Rest has helped me feel a little better. Exerting myself in any way just makes me feel worse. Jeffrey has also been bringing me hot tea and soup. We’ve also kept my humidifier going. Other than that, I tried taking aspirin to help with my fever and chest pain, but that didn’t give me much relief. | ||
| how bad is the pain? | Question 03/25/20 1:00 AM CDT |
| I think that this cough is pretty severe. It brings my chest pain up from a 2 out of 10 to a 5 out of 10. | ||
| sorry to hear that | Empathize 03/25/20 1:01 AM CDT |
| Well, that’s very nice. | ||
| Lets talk about your past medical history (Clarified to What is your past medical history?.) | Question 03/25/20 1:01 AM CDT |
| I have hypertension and chronic kidney disease. stage 2. (Clarified to what health problems I have had.) | ||
| how long have you had the conditions? (Clarified to How long have you had your preexisting health problems?.) | Question 03/25/20 1:02 AM CDT |
| I was diagnosed with stage 2 chronic kidney disease 9 years ago, when I had some blood work done for my hypertension. I don’t know how long I had it before that, but I was diagnosed with hypertension 14 years ago, so it could have been a long time. (Clarified to how long I have had my preexisting health problems.) | ||
| any recent hospitalizations? | Question 03/25/20 1:03 AM CDT |
| I have not been hospitalized recently. | ||
| do you have any allergies | Question 03/25/20 1:03 AM CDT |
| No, I don’t have allergies. | ||
| Are you up to date on vaccines? | Question 03/25/20 1:04 AM CDT |
| Let me think . . . I had a flu shot about three months ago. Other than that, it’s been quite a while since I’ve needed any vaccines. I had a pneumococcal vaccine 12 years ago. | ||
| You are due for a pneumococcal vaccine, which you should receive again in your adulthood five to ten years after your first shot. These vaccines protect against the bacteria that most commonly cause pneumonia. | Educate 03/25/20 1:07 AM CDT |
| Alright. | ||
| What medications do you take? | Question 03/25/20 1:09 AM CDT |
| I take two prescription medications; a trandolapril/verapamil combo and chlorothiazide. I also take two supplements, vitamin D and calcium. And for the last three days I’ve been taking aspirin. | ||
| tell me about the trandolapril/verapamil | Question 03/25/20 1:10 AM CDT |
| I take my trandolapril/verapamil once a day for my stage 2 chronic kidney disease and hypertension. | ||
| how long have you taken the chlorothiazide? | Question 03/25/20 1:11 AM CDT |
| I have taken chlorothiazide for 14 years. | ||
| what's is the dosage of your medications? | Question 03/25/20 1:11 AM CDT |
| The trandolapril/verapamil combination is 2 milligrams of trandolapril and 180 milligrams of verapamil. The chlorothiazide pill is 500 milligrams. The aspirin is 325 milligrams each pill. As for the supplements: the calcium is 1200 milligrams and the vitamin D is 15 micrograms. | ||
| are you compliant with all of your medications? (Clarified to Are you compliant with your medications?.) | Question 03/25/20 1:12 AM CDT |
| I never miss doses of my medication. Jeffrey and I are very diligent, and the pillbox keeps track for us. (Clarified to if I am compliant with medication.) | ||
| That is great | Empathize 03/25/20 1:13 AM CDT |
| Thank you. I appreciate that. | ||
| what you taken any antibiotics? (Clarified to Have you taken antibiotics recently?.) | Question 03/25/20 1:13 AM CDT |
| I haven’t taken any antibiotics in some time . . . I honestly can’t remember when that would’ve been. (Clarified to if I have taken antibiotics recently.) | ||
| Do you drink, smoke, or use illicit substances? | Question 03/25/20 1:14 AM CDT |
| I’ve never used any illicit drugs. | ||
| do you exercise? | Question 03/25/20 1:15 AM CDT |
| I try to stay active by taking a few short walks a week. Jeffrey and I will walk around our neighborhood for about ten minutes. We try to do this two or three times a week. Unfortunately, right now all I can do is rest. | ||
| any difficulties with activities of daily living? (Clarified to Do you have trouble performing daily activities?.) | Question 03/25/20 1:16 AM CDT |
| I’ve been struggling a little with everything of late, but I am quite capable in general, thank you. [AUDIO COMING SOON] (Clarified to if I have trouble performing daily activities.) | ||
| tell me about your diet? | Question 03/25/20 1:16 AM CDT |
| In the morning, Jeffrey and I will have a piece of toast with some eggs, or maybe a fresh croissant that he picks up from the bakery around the corner. We normally eat a very light lunch — a sandwich, or some homemade soup — and for dinner we like to go out to eat a few times a week. Normally we get pasta, or a salad. | ||
| For people with hypertension and with chronic kidney disease, some foods are healthier and safer than others. It’s important to consider how your health will be affected when making everyday meal choices. | Empathize 03/25/20 1:18 AM CDT |
| That’s kind of you to say. | ||
| what's your family medical history | Question 03/25/20 1:20 AM CDT |
| My parents have both passed away. My mother was fairly healthy, but my father had hypertension. [AUDIO COMING SOON] | ||
| just want to follow up on the aspirin (No matching questions found.) | Question 03/25/20 1:20 AM CDT |
| How often do you take the aspirin | Question 03/25/20 1:20 AM CDT |
| Not normally, but since I got sick three days ago, I have been taking two aspirins three times a day. That’s a 325 milligram pill. | ||
| does it help with pain? | Educate 03/25/20 1:21 AM CDT |
| I’ll keep that in mind. | ||
| does it help with pain (No matching questions found.) | Question 03/25/20 1:21 AM CDT |
| does the aspirin relieve your pain | Question 03/25/20 1:22 AM CDT |
| It has done a little good, I suppose, both for my chest pain and my fever . . . I suppose it’s hard to tell, though, because I’ve been taking it since my symptoms started, so I haven’t really felt how bad my symptoms are sans aspirin. [AUDIO COMING SOON] | ||
| While it’s great that the aspirin has relieved your symptoms, it is not approved for older adults nor for people taking some of your medications. Always ask a healthcare provider before starting a new medication. | Educate 03/25/20 1:24 AM CDT |
| I’ll remember that. | ||
| Hi, i will educate you on the new prescription | Question 03/25/20 1:38 AM CDT |
| I appreciate it. | ||
| Take the medication with a full glass of water | Question 03/25/20 1:38 AM CDT |
| Shouldn’t be a problem. | ||
| Take the full course of medications | Question 03/25/20 1:39 AM CDT |
| I’ll be sure to take the whole course. | ||
| Be sure to avoid the sun | Question 03/25/20 1:39 AM CDT |
| I won’t be leaving my bed much anyway. | ||
| Contact your doctor if you experience rapid weight gain | Question 03/25/20 1:40 AM CDT |
| Alright then. | ||
| call 911 if you show signs of a severe allergic reaction | Question 03/25/20 1:40 AM CDT |
| I’ll have Jeffrey call 911 if that happens. | ||
| take Tylenol for pain and fever | Question 03/25/20 1:41 AM CDT |
| Thanks for that. | ||
| guaifenesin will help with your cough | Question 03/25/20 1:41 AM CDT |
| Good to know. | ||
| you should start feeling better in a few days | Question 03/25/20 1:42 AM CDT |
| Hmm. Okay. | ||
| drink plenty of fluids | Question 03/25/20 1:42 AM CDT |
| I can do that. Does tea work? | ||
| yes Mrs. Douglas | Question 03/25/20 1:42 AM CDT |
| That works for me. | ||
| Thank you | Question 03/25/20 1:42 AM CDT |
| Alright. Thank you for all of your help today. |
