Focused Exam: COPD Debbie O’Connor shadow health transcript

Focused Exam: COPD Debbie O’Connor shadow health Transcript

Focused Exam: COPD Debbie O’Connor shadow health transcript sample

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 Total Time:125 min

Your avatarHello Debbie O’Connor, My name is Danielle Scott. I will be your provider today.Greet
03/30/20 3:44 PM CDT
Debbie O'ConnorHello.
Your avatarCan you verify your Name and birthday?Question
03/30/20 3:44 PM CDT
Debbie O'ConnorI was born on October 5 . . . [Ms. O’Connor reports the correct birth year.]
Your avatarWhat brings you in today?Question
03/30/20 3:44 PM CDT
Debbie O'ConnorI’m having so much trouble just trying to breathe. And I’ve had these terrible coughing fits. A few days ago, a bronchospasm. My health is going downhill fast . . . I know it has to do with my smoking habit. It’s so hard to kick. I was hoping I could get something to help me.
Your avatarI’m sorry to hear that you are experiencing anxiety over your current health conditions. Not being able to breathe is a scary condition. With the right therapy, and if you quit smoking, you’ll begin to feel better.Empathize
03/30/20 3:47 PM CDT
Debbie O'ConnorThat’s very kind.
Your avatarAre you experiencing any other symptoms?Question
03/30/20 3:48 PM CDT
Debbie O'ConnorI feel exhausted. I’m just so weak now, that even walking up the stairs feels exhausting. I had this awful coughing fit three days ago. But I’ve had trouble breathing for several months now. I’ve also been coughing up some nasty phlegm.
Your avatarWhen did you start coughing up the phlegmQuestion
03/30/20 3:50 PM CDT
Debbie O'ConnorI cough up sputum all the time. It’s been like this for a couple of weeks. It’s this dark gray — or sometimes yellow color.
Your avatarAny aggravating factors?Question
03/30/20 3:51 PM CDT
Debbie O'ConnorHonestly, smoking makes my breathing worse. I have these terrible coughing fits afterwards. Kind of a no-brainer, but I can’t help myself. I can’t handle the withdrawal, so I just try to hold out between cigarettes as long as I can.
Your avatarIs there anything that relieves the symptoms?Question
03/30/20 3:52 PM CDT
Debbie O'ConnorNothing seems to make my symptoms feel better — not even my inhaler. I know for sure that smoking makes it worse. I try to hold off as long as I can between cigs. But still . . . I think if I quit I’d feel better.
Your avatarHow bad is you breathing? (Clarified to How severe are your breathing problems?.)Question
03/30/20 3:52 PM CDT
Debbie O'ConnorBreathing is so hard, all the time. I guess I’d put it at a 6 out of 10. (Clarified to how severe my breathing problems are.)
Your avatarHow does your health affect your social life?Question
03/30/20 3:53 PM CDT
Debbie O'ConnorMy breathing problems sure aren’t helping my social life any. I was never exactly a social butterfly, but now I’m not up to going out. Even normal things–shopping, picking up my meds.
Your avatarDo you have any other existing health conditions?Question
03/30/20 3:54 PM CDT
Debbie O'ConnorI’ve only got Group B COPD. The chronic bronchitis kind. [AUDIO COMING SOON]
Your avatarAny recent hospitalizations?Question
03/30/20 3:55 PM CDT
Debbie O'ConnorI haven’t been to the hospital in about two years. I had a bad breathing episode and they said I had COPD.
Your avatarWhat medications are you currently taking?Question
03/30/20 3:57 PM CDT
Debbie O'ConnorI have an inhaler that I use for my COPD — a formoterol inhaler.
Your avatarHow often you do you use your inhaler?Question
03/30/20 3:58 PM CDT
Debbie O'ConnorI use it twice a day, morning and night. Every 12 hours.
Your avatarWhats the dosage of the inhaler?Question
03/30/20 3:58 PM CDT
Debbie O'ConnorI take 12 micrograms of formoterol.
Your avatarDo you take any supplements or vitamins?Question
03/30/20 3:59 PM CDT
Debbie O'ConnorI don’t take any vitamins or supplements or any of that stuff.
Your avatarAre you complaint with your medicine? (No matching questions found.)Question
03/30/20 3:59 PM CDT
Your avatarDo you miss doses of medications? (Clarified to Do you miss doses of your medication?.)Question
03/30/20 4:00 PM CDT
Debbie O'ConnorNo, I never miss doses. I use my inhaler once in the morning and once at night. I find that easy enough to remember. (Clarified to if I miss doses of my medication.)
Your avatarDo you use a spirometer?Question
03/30/20 4:00 PM CDT
Debbie O'ConnorI have a spirometer, yes. Only use it sometimes. Got an FEV1 reading of 1.37 L the other day. That’s 49%.
Your avatarDo you have any allergies?Question
03/30/20 4:01 PM CDT
Debbie O'ConnorI don’t have any allergies, never had an allergic reaction . . . nothing like that.
Your avatarDo you use home oxygen?Question
03/30/20 4:01 PM CDT
Debbie O'ConnorI don’t use oxygen . . . it could probably help me. But I’d blow myself up, smoking near it.
Your avatarOxygen therapy could help alleviate some of your symptoms of breathlessness and fatigue. Unfortunately, you cannot use oxygen therapy if you smoke. It’s too dangerous. Once you quit smoking, you can seek this treatment.Educate
03/30/20 4:04 PM CDT
Debbie O'ConnorYou certainly know your stuff.
Your avatarHave you had any vaccines?Question
03/30/20 4:05 PM CDT
Debbie O'ConnorI’ve had vaccines before, but . . . it’s been a long time.
Your avatarAt your age, and with your health conditions, it’s vital that you get an annual flu shot, and that you receive a pneumococcal vaccine every ten years. These two infections could have terrible effects on your health because your respiratory system is already compromised.Educate
03/30/20 4:08 PM CDT
Debbie O'ConnorThat’s good to know.
Your avatarDo you live at home alone?Question
03/30/20 4:11 PM CDT
Debbie O'ConnorI live with my daughter, Ava. I moved in when my health started getting worse. She takes care of me.
Your avatardo you drink alcohol?Question
03/30/20 4:11 PM CDT
Debbie O'ConnorI don’t touch the stuff. My daddy was a drinker, and I saw what it did to him.
Your avatarAny substance abuse?Question
03/30/20 4:12 PM CDT
Debbie O'ConnorNo, that never appealed to me.
Your avatarhow long have you been a smokerQuestion
03/30/20 4:12 PM CDT
Debbie O'ConnorI started smoking when I was 15. I’ve smoked for a long time. Had a little success quitting. I stopped for ten years when my daughter was born. But, I picked up the habit again. I’ve tried quitting since my husband died, but . . . it’s hard.
Your avatarI’m sorry that you lost your husband. That sounds like it must have been very difficult for you.Empathize
03/30/20 4:15 PM CDT
Debbie O'ConnorThanks.
Your avatarhow many cigarettes do you smoke per dayQuestion
03/30/20 4:15 PM CDT
Debbie O'ConnorTypically I smoke between three and five cigarettes a day. It’s been that way for the last four months. Ever since I relapsed. Smoking makes my breathing worse, so . . . I try to hold off as long as I can between cigarettes.
Your avatarIt’s vital that you quit smoking as soon as possible in order to get some relief from you COPD symptoms. Smoking is putting your life in danger and making your symptoms worse. I can point you towards community or national smoking cessation programs that can help support you while you are quitingEducate
03/30/20 4:20 PM CDT
Debbie O'ConnorI’ll be sure to keep that in mind.
Your avatarDo you exercise?Question
03/30/20 4:20 PM CDT
Debbie O'ConnorI can’t exercise. I can’t even move around the house without feeling fatigued and out of breath. Exerting myself in any way makes me feel worse.
Your avatarTell me about your diet?Question
03/30/20 4:21 PM CDT
Debbie O'ConnorWell, I’m too weak to cook. I eat microwavable meals if I’m alone. Pasta, pizza, rice, all that. My daughter cooks nice food . . . quinoa, salads, salmon.
Your avatarWhen you COPD symptoms have been alleviated it is important that you try to eat well and get some light exercise. Not exercising can exacerbate your symptoms, and some exercise will help you breathe easier and build lung capacityEducate
03/30/20 4:23 PM CDT
Debbie O'ConnorOh! That makes sense.
Your avatarAny family history of illness?Question
03/30/20 4:24 PM CDT
Debbie O'ConnorMy parents died from smoking their whole lives. It was a different time . . . my father had a heart attack at 42. My mother edged him out, but she eventually got pneumonia.
Your avatarChanges in your weight? (Clarified to Has your weight changed recently?.)Question
03/30/20 4:24 PM CDT
Debbie O'ConnorI’ve gained 30 pounds these past two years. (Clarified to if I have had weight changes recently.)
Your avatarDo you have any problems with your visionQuestion
03/30/20 4:26 PM CDT
Debbie O'ConnorI’m nearsighted, but my glasses work fine.
Your avatarhave you noticed any shin issues (No matching questions found.)Question
03/30/20 4:26 PM CDT
Your avatarAny skin changes?Question
03/30/20 4:27 PM CDT
Debbie O'ConnorSkin’s been turning yellow around my mouth and fingers. From cigarettes, I’m sure. At least I haven’t turned blue.
Your avatarAny issues with your menses (No matching questions found.)Question
03/30/20 4:28 PM CDT
Your avatarWHen was you last periodQuestion
03/30/20 4:28 PM CDT
Debbie O'ConnorI haven’t had a period since I went through menopause.
Your avatarDo you work?Question
03/30/20 4:28 PM CDT
Debbie O'ConnorI’m retired. Used to be an office manager.
Your avatarHello, I have written some prescriptionsQuestion
03/30/20 5:02 PM CDT
Debbie O'ConnorSure thing, honey.
Your avatarFor the tiotropium inhaler, take missed dose as soon as possible.Question
03/30/20 5:03 PM CDT
Debbie O'ConnorOk. I understand.
Your avataruse the rescue inhaler for acute symptomsQuestion
03/30/20 5:03 PM CDT
Debbie O'ConnorI’ll be sure to do just that.
Your avatardo not swallow the capsules, they should be inhaled with the inhalerQuestion
03/30/20 5:04 PM CDT
Debbie O'ConnorI understand.
Your avatarInhale the capsule twice to get the full doseQuestion
03/30/20 5:04 PM CDT
Debbie O'ConnorAlright.
Your avatarstop the medication and contact the doctor if you experience bronchospasm immediately after a treatmentQuestion
03/30/20 5:06 PM CDT
Debbie O'ConnorIsn’t this inhaler supposed to keep that from happening?
Your avataryes, youre right. thats why it is important to contact usQuestion
03/30/20 5:06 PM CDT
Debbie O'ConnorAlright. I think I understand.
Your avatarcommon side effects will be dry mouthQuestion
03/30/20 5:07 PM CDT
Debbie O'ConnorAlright.
Your avatarkeep the capsules inside the packagingQuestion
03/30/20 5:07 PM CDT
Debbie O'ConnorUnderstood.
Your avatarbe sure to use the medication as recommendedQuestion
03/30/20 5:08 PM CDT
Debbie O'ConnorOkay.
Your avatarprep the inhaler before useQuestion
03/30/20 5:08 PM CDT
Debbie O'ConnorI’ll be sure to keep that in mind.
Your avatarseek help if you can not control your breathingQuestion
03/30/20 5:09 PM CDT
Debbie O'ConnorI sure hope that doesn’t happen.
Your avataryou might feel nervousQuestion
03/30/20 5:09 PM CDT
Debbie O'ConnorThank you for letting me know. I’ll keep an eye out for that.
Your avatarfor the varenicline take missed dose as soon as possibleQuestion
03/30/20 5:10 PM CDT
Debbie O'ConnorI’ll be sure to do just that.
Your avatarbegin smoking cessation counseling immediatelyQuestion
03/30/20 5:11 PM CDT
Debbie O'ConnorI won’t stop trying to quit, no matter what. I have to make it happen this time.
Your avatarit will cause dry mouthQuestion
03/30/20 5:11 PM CDT
Debbie O'ConnorI can try to deal with that if it happens.
Your avatarstop medication if you experience an allergic reactionQuestion
03/30/20 5:12 PM CDT
Debbie O'ConnorI’ll keep an eye out for those side effects.
Your avatarcontact provider if you have thoughts of hurting yourself or depressionQuestion
03/30/20 5:13 PM CDT
Debbie O'ConnorThat’s awful scary. Are you sure I should be taking this medicine?
Your avatarIts rare, we just want to be safeQuestion
03/30/20 5:13 PM CDT
Debbie O'ConnorAlright. As long as you think it will work.
Your avataranything else?Question
03/30/20 5:13 PM CDT
Debbie O'ConnorOk. See you later.

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