Tina Jones Respiratory Shadow Health Transcript

Tina Jones Respiratory Shadow Health Transcript

Transcript

Started: Jul 22, 2022 | Total Time: 168 min
Your Avatar.
Hi Ms Jones, I’m xx and I’m going to examine you today.

Greet
07/22/22 1:55 PM MDT

Tina Jones.
Hey.
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Can you verify your name and date of birth?

Question
07/22/22 1:55 PM MDT

Tina Jones.
My name’s Tina Jones, and my birthday’s February 17th.
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What brings you in today?

Question
07/22/22 1:56 PM MDT

Tina Jones.
I came in because I’ve been having breathing problems, and my inhaler just isn’t working the way it normally does.
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I’m sorry to hear you’re going through that.

Empathize
07/22/22 1:56 PM MDT

Tina Jones.
Thanks for understanding.
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Can you please describe what’s going on with your inhaler? (No matching questions found.)

Question
07/22/22 1:57 PM MDT

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Can you please describe what breathing problems you’re having? (Clarified to Can you describe your breathing problems?.)

Question
07/22/22 1:57 PM MDT

Tina Jones.
It feels like it’s been hard to take in air. My chest feels all tight and I’ve been wheezing… I’ve had to use my inhaler a lot, and it doesn’t feel like it’s totally working. (Clarified to to describe my breathing problems.)
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Do you know what are causing your asthma to flare up? (Clarified to What started your recent asthma problems?.)

Question
07/22/22 1:58 PM MDT

Tina Jones.
This all started at my cousin’s house. She has cats, and I’m allergic, so my asthma always goes crazy when I’m there. (Clarified to what triggered my recent asthma problems.)
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When was your most recent asthma exacerbation?

Question
07/22/22 1:59 PM MDT

Tina Jones.
The last time I had real trouble breathing was early this morning. But it’s been going on for the past two days.
Your Avatar.
How many puffs of your inhaler do you use when your asthma symptoms flare up?

Question
07/22/22 2:01 PM MDT

Tina Jones.
Sometimes I have to take three puffs of the 90 mcg albuterol inhaler instead of two, and the past couple days, always three. [AUDIO COMING SOON]
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How often are you around cats?

Question
07/22/22 2:01 PM MDT

Tina Jones.
Not often. Just at my cousin’s house. . . and I’m only there a few times a year.
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What else triggers your asthma besides cats?

Question
07/22/22 2:01 PM MDT

Tina Jones.
For the last two days, it seems worse at night when I’m lying down, or when I’m moving around too much. Typically it’s stuff like cats or dust that gets to me.
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Do you have any other respiratory illnesses?

Question
07/22/22 2:02 PM MDT

Tina Jones.
No, just the asthma.
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How long have you had asthma?

Question
07/22/22 2:02 PM MDT

Tina Jones.
I’ve had asthma a long time. . . since I was really little.
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How do you manage your asthma?

Question
07/22/22 2:03 PM MDT

Tina Jones.
I try to avoid things that give me breathing problems, but when my asthma starts to act up, I just use my inhaler.
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How is your breathing currently?

Question
07/22/22 2:03 PM MDT

Tina Jones.
My breathing feels okay right this second, but I’ve definitely been having problems recently with it.
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How severe is your asthma?

Question
07/22/22 2:03 PM MDT

Tina Jones.
My asthma used to be really scary. I haven’t had a full attack in years, and if you had asked me before this I would have said my asthma wasn’t that bad anymore, but the last couple days I’ve had a lot of trouble breathing.
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What other symptoms have you had besides trouble breathing?

Question
07/22/22 2:04 PM MDT

Tina Jones.
Other than what I’ve told you? I don’t think so. It’s just needing my inhaler so much and the cough that’s been bothering me.
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Tell me more about your cough

Question
07/22/22 2:05 PM MDT

Tina Jones.
Um. . . I guess I’d describe it as a small, dry cough.
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When did this cough start?

Question
07/22/22 2:05 PM MDT

Tina Jones.
Two days ago, a little while after I first started having these asthma problems.
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Do you have any sputum with this cough?

Question
07/22/22 2:05 PM MDT

Tina Jones.
No, nothing’s coming up.
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How often do you cough?

Question
07/22/22 2:06 PM MDT

Tina Jones.
I’ve been coughing pretty much all the time.
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What are your allergies?

Question
07/22/22 2:06 PM MDT

Tina Jones.
I’m allergic to cats.
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Any other allergy besides cats? (Clarified to Are you allergic to anything besides cats?.)

Question
07/22/22 2:06 PM MDT

Tina Jones.
Yeah, I’m allergic to penicillin. (Clarified to if I am allergic to anything besides cats.)
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When did you have an allergic reaction to penicillin? (Clarified to Have you had an allergic reaction to penicillin?.)

Question
07/22/22 2:07 PM MDT

Tina Jones.
Yeah, but it was a long time ago, when I was little. . . the doctor told me not to take it again after that. (Clarified to if I have had a reaction to penicillin.)
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What happens when you take penicillin?

Question
07/22/22 2:08 PM MDT

Tina Jones.
I don’t remember that well because the last time I had penicillin I was pretty little. . . I think I got a rash, like, hives. The doctor told me not to take it again after that.
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How severe was your reaction to penicillin?

Question
07/22/22 2:08 PM MDT

Tina Jones.
It was a long time ago, so I don’t remember that well, but I don’t think it was that serious. I just got a rash–like, hives–I think. . . then the doctor said not to take penicillin again, so I didn’t.
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Do you have any environmental allergies?

Question
07/22/22 2:09 PM MDT

Tina Jones.
No, unless cats count.
Your Avatar.
Can you describe what happens when you’re around cats?

Question
07/22/22 2:09 PM MDT

Tina Jones.
Whenever I’m around cats, I start sneezing, my eyes get itchy, my nose runs. . . and my asthma starts to act up.
Your Avatar.
How do your treat your allergy to cats?

Question
07/22/22 2:10 PM MDT

Tina Jones.
I try not to be around cats at all, but when I have to be around them and my breathing gets bad, I use my inhaler. . . but I don’t totally feel better until I go home and take a shower.
Your Avatar.
You mentioned your asthma flares up when you’re around dust. What happens when you’re around dust?

Question
07/22/22 2:10 PM MDT

Tina Jones.
If I’m around a lot of dust, I can get sneezy, or I can start wheezing.
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Do you smoke?

Question
07/22/22 2:11 PM MDT

Tina Jones.
No. I think it’s gross.
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Do you use any recreational drugs?

Question
07/22/22 2:11 PM MDT

Tina Jones.
No.
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Do you use marijuana?

Question
07/22/22 2:11 PM MDT

Tina Jones.
Um, yeah, I’ve done that before. In high school, and after high school… I definitely don’t anymore, though.
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When was the last time you used marijuana?

Question
07/22/22 2:12 PM MDT

Tina Jones.
I haven’t smoked pot since I was twenty or twenty-one.
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Are you around secondhand smoke?

Question
07/22/22 2:12 PM MDT

Tina Jones.
Some of my friends smoke when we go out drinking. But I don’t smoke, and nobody at home smokes.
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How often are you around your friends that smoke? (Clarified to How often are you around people who smoke?.)

Question
07/22/22 2:12 PM MDT

Tina Jones.
Some of my friends smoke when we go out drinking. But I don’t smoke, and nobody at home smokes. (Clarified to how often I am around secondhand smoke.)
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Does anyone in your family have asthma?

Question
07/22/22 2:13 PM MDT

Tina Jones.
It’s just me and my baby sister that have asthma, but she really doesn’t have problems with it.
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Did your parents or grandparents have asthma?

Question
07/22/22 2:13 PM MDT

Tina Jones.
Yeah. Both Nana and Poppa died about five years ago.
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I’m so sorry to hear that

Empathize
07/22/22 2:14 PM MDT

Tina Jones.
Thanks for saying that.
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What did your father die of?

Question
07/22/22 2:14 PM MDT

Tina Jones.
He died in a car accident.
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What happened in the car accident?

Question
07/22/22 2:15 PM MDT

Tina Jones.
He was driving to work and it was raining…and his car hydroplaned. And hit a tree. So it was really sudden.
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How did your grandfather die?

Question
07/22/22 2:16 PM MDT

Tina Jones.
Well, Grandpa Jones died of colon cancer, and Poppa died of a heart attack.
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Does your family have a history of lung cancer?

Question
07/22/22 3:19 PM MDT

Tina Jones.
The only cancer that I know of in our family is colon cancer–Grandpa Jones died of that.
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Does your family have a history of respiratory illness?

Question
07/22/22 3:19 PM MDT

Tina Jones.
My baby sister has asthma, too, but no one else in the family has lung problems, I don’t think.
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Do you have a history of bronchitis, pneumonia or emphysema?

Question
07/22/22 3:20 PM MDT

Tina Jones.
Nope, never.
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 Inspected anterior chest wall

Exam Action
07/22/22 3:22 PM MDT

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 Inspected left side chest wall

Exam Action
07/22/22 3:22 PM MDT

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 Inspected posterior chest wall

Exam Action
07/22/22 3:22 PM MDT

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 Inspected right side chest wall

Exam Action
07/22/22 3:23 PM MDT

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 Inspected anterior chest wall

Exam Action
07/22/22 3:23 PM MDT

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 Palpated chest expansion: Both sides rise symmetrically

Exam Action
07/22/22 3:23 PM MDT

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 Palpated fremitus in anterior lower chest wall: Equal bilaterally, expected vibration

Exam Action
07/22/22 3:23 PM MDT

Tina Jones.
Ninety-nine.
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 Palpated fremitus in anterior upper chest wall: Equal bilaterally, expected vibration

Exam Action
07/22/22 3:23 PM MDT

Tina Jones.
Ninety-nine.
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 Palpated chest expansion: Both sides rise symmetrically

Exam Action
07/22/22 3:37 PM MDT

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 Percussed anterior left upper lobe

Exam Action
07/22/22 3:41 PM MDT

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 Percussed anterior right upper lobe

Exam Action
07/22/22 3:41 PM MDT

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 Percussed anterior left mid-chest (upper lobe)

Exam Action
07/22/22 3:41 PM MDT

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 Percussed anterior right middle lobe

Exam Action
07/22/22 3:41 PM MDT

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 Percussed anterior right lower lobe

Exam Action
07/22/22 3:41 PM MDT

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 Percussed anterior left lower lobe

Exam Action
07/22/22 3:41 PM MDT

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 Percussed posterior right upper lobe

Exam Action
07/22/22 3:42 PM MDT

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 Percussed posterior left upper lobe

Exam Action
07/22/22 3:42 PM MDT

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 Percussed posterior left mid-back (lower lobe)

Exam Action
07/22/22 3:42 PM MDT

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 Percussed posterior right mid-back (lower lobe)

Exam Action
07/22/22 3:42 PM MDT

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 Percussed posterior right lower lobe

Exam Action
07/22/22 3:42 PM MDT

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 Percussed posterior left mid-back (lower lobe)

Exam Action
07/22/22 3:42 PM MDT

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 Percussed posterior left lower lobe

Exam Action
07/22/22 3:42 PM MDT

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 Percussed posterior left lower lobe on side

Exam Action
07/22/22 3:42 PM MDT

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 Percussed posterior left lower lobe near spine

Exam Action
07/22/22 3:42 PM MDT

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 Percussed posterior right lower lobe

Exam Action
07/22/22 3:42 PM MDT

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 Percussed posterior right lower lobe near spine

Exam Action
07/22/22 3:42 PM MDT

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 Percussed posterior right lower lobe on side

Exam Action
07/22/22 3:42 PM MDT

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 Percussed posterior right lower lobe on side

Exam Action
07/22/22 3:42 PM MDT

Your Avatar.
 Auscultated breath sounds in anterior left upper lobe

Exam Action
07/22/22 3:43 PM MDT

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 Auscultated breath sounds in anterior right upper lobe

Exam Action
07/22/22 3:43 PM MDT

Your Avatar.
 Auscultated breath sounds in anterior right middle lobe

Exam Action
07/22/22 3:43 PM MDT

Your Avatar.
 Auscultated breath sounds in anterior left upper lobe

Exam Action
07/22/22 3:43 PM MDT

Your Avatar.
 Auscultated breath sounds in anterior left mid-chest (upper lobe)

Exam Action
07/22/22 3:43 PM MDT

Your Avatar.
 Auscultated breath sounds in anterior left lower lobe

Exam Action
07/22/22 3:43 PM MDT

Your Avatar.
 Auscultated breath sounds in anterior right lower lobe

Exam Action
07/22/22 3:43 PM MDT

Your Avatar.
 Auscultated breath sounds in posterior left upper lobe

Exam Action
07/22/22 3:44 PM MDT

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 Auscultated breath sounds in posterior right upper lobe

Exam Action
07/22/22 3:44 PM MDT

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 Auscultated breath sounds in posterior right mid-back (lower lobe)

Exam Action
07/22/22 3:44 PM MDT

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 Auscultated breath sounds in posterior left mid-back (lower lobe)

Exam Action
07/22/22 3:44 PM MDT

Your Avatar.
 Auscultated breath sounds in posterior left lower lobe

Exam Action
07/22/22 3:44 PM MDT

Your Avatar.
 Auscultated breath sounds in posterior right lower lobe

Exam Action
07/22/22 3:45 PM MDT

Your Avatar.
 Auscultated breath sounds in posterior left lower lobe on side

Exam Action
07/22/22 3:45 PM MDT

Your Avatar.
 Auscultated breath sounds in posterior left lower lobe near spine

Exam Action
07/22/22 3:46 PM MDT

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 Auscultated breath sounds in posterior right lower lobe near spine

Exam Action
07/22/22 4:01 PM MDT

Your Avatar.
 Auscultated breath sounds in posterior right lower lobe on side

Exam Action
07/22/22 4:01 PM MDT

Your Avatar.
 Auscultated breath sounds in posterior right lower lobe

Exam Action
07/22/22 4:01 PM MDT

Your Avatar.
 Auscultated breath sounds in posterior left lower lobe

Exam Action
07/22/22 4:01 PM MDT

Your Avatar.
 Auscultated breath sounds in posterior right mid-back (lower lobe)

Exam Action
07/22/22 4:01 PM MDT

Your Avatar.
 Auscultated breath sounds in posterior left mid-back (lower lobe)

Exam Action
07/22/22 4:01 PM MDT

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 Auscultated breath sounds in posterior left upper lobe

Exam Action
07/22/22 4:01 PM MDT

Your Avatar.
 Auscultated breath sounds in posterior left mid-back (lower lobe)

Exam Action
07/22/22 4:01 PM MDT

Your Avatar.
 Auscultated breath sounds in anterior left upper lobe

Exam Action
07/22/22 4:02 PM MDT

Your Avatar.
 Auscultated breath sounds in anterior right upper lobe

Exam Action
07/22/22 4:02 PM MDT

Your Avatar.
 Auscultated breath sounds in anterior right middle lobe

Exam Action
07/22/22 4:02 PM MDT

Your Avatar.
 Auscultated breath sounds in anterior left mid-chest (upper lobe)

Exam Action
07/22/22 4:02 PM MDT

Your Avatar.
 Auscultated breath sounds in anterior left lower lobe

Exam Action
07/22/22 4:02 PM MDT

Your Avatar.
 Auscultated breath sounds in anterior right lower lobe

Exam Action
07/22/22 4:02 PM MDT

Your Avatar.
 Auscultated breath sounds in anterior left lower lobe

Exam Action
07/22/22 4:03 PM MDT

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 Auscultated breath sounds in anterior right lower lobe

Exam Action
07/22/22 4:04 PM MDT

Your Avatar.
 Auscultated voice sounds in anterior right upper lobe

Exam Action
07/22/22 4:04 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in anterior right upper lobe

Exam Action
07/22/22 4:05 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in anterior left upper lobe

Exam Action
07/22/22 4:05 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in anterior left mid-chest (upper lobe)

Exam Action
07/22/22 4:06 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in anterior right middle lobe

Exam Action
07/22/22 4:06 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in anterior left lower lobe

Exam Action
07/22/22 4:06 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in anterior right lower lobe

Exam Action
07/22/22 4:06 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in posterior right upper lobe

Exam Action
07/22/22 4:06 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in posterior right mid-back (lower lobe)

Exam Action
07/22/22 4:09 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in posterior right lower lobe

Exam Action
07/22/22 4:10 PM MDT

Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in posterior left lower lobe

Exam Action
07/22/22 4:10 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in posterior right lower lobe on side

Exam Action
07/22/22 4:10 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in posterior right lower lobe near spine

Exam Action
07/22/22 4:10 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in posterior left lower lobe near spine

Exam Action
07/22/22 4:10 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in posterior left lower lobe on side

Exam Action
07/22/22 4:11 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in anterior left lower lobe

Exam Action
07/22/22 4:15 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Auscultated voice sounds in anterior right lower lobe

Exam Action
07/22/22 4:15 PM MDT

Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Tina Jones.
Ninety-nine.
Your Avatar.
 Check pulse oximetry using right hand

Exam Action
07/22/22 4:20 PM MDT

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 Checked pulse oximetry using left hand

Exam Action
07/22/22 4:20 PM MDT

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Ms. Jones can you please blow into the spirometer?

Question
07/22/22 4:22 PM MDT

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 Checked spirometer

Exam Action
07/22/22 4:22 PM MDT

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 Checked patient’s inhaler

Exam Action
07/22/22 4:23 PM MDT

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Do you see an asthma specialist?

Question
07/22/22 4:25 PM MDT

Tina Jones.
I used to go to Dr. Dewitt, but she moved her practice recently. Luckily she’s still been able to call in refills of my inhaler, but I haven’t actually been in to see her in about two years.
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Have you had any hospitalizations?

Question
07/22/22 4:26 PM MDT

Tina Jones.
I went to the hospital a bunch of times when I was growing up, for asthma attacks. And I went for a foot injury a few months ago, but my foot is fine now.
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At the time of your asthma attack, how severe was it?

Question
07/22/22 7:03 PM MDT

Tina Jones.
My asthma used to be really scary. I haven’t had a full attack in years, and if you had asked me before this I would have said my asthma wasn’t that bad anymore, but the last couple days I’ve had a lot of trouble breathing.
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What number on a scale of 0 to 10 would you rate the severity? (Clarified to How would you rate the severity of your asthma on a scale from one to ten?.)

Question
07/22/22 7:04 PM MDT

Tina Jones.
At its worst it’s been like a 7 or 8 out of 10, probably. (Clarified to how I would rate my asthma on a scale.)
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How you rate your shortness of breath from a scale of 0 to 10?
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