Dictation Practice – Part A06

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Audio

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Answer

brown
fatigued
walk
ribs
tingling
glandular fever
chest infections
insomnia
sense of smell
statin
antidepressants
hay fever (seasonal rhinitis)

Transcript

Doctor:	Now Pam, I see you’ve been referred to me by your GP and I’ve got your notes here. But perhaps we could start by (you) telling me in your own words about the symptoms that you’ve been having, any treatment you’ve had, how that’s gone and anything else you feel I should know.
Patient:	Well, to be honest I’ve just been feeling absolutely terrible. I’ve got this awful cough that just won’t go away no matter what I do. And I keep coughing up all this stuff. It’s sort of brown, it looks horrible. And the cough is much worse at night. So of course that’s been interfering with my sleep. So I’m what you would probably call fatigued all the time. I feel like I have to try to get through every day rather than live it. It doesn’t help that weirdly. I’m just not hungry at the moment either. I’m really off my food and that’s led to me losing weight – which is probably a good thing. But it’s not helping with my energy levels.
Doctor:	Are you otherwise well? I mean, have you noticed any other changes in your health?
Patient:	Well, one quite big thing is that I’m finding it difficult to walk very far. I can manage short distances but if it’s going to take longer than 10 minutes you can forget it. And then just a few little aches and pains but they can be annoying. I’ve noticed that my ribcage feels really painful when I’ve been laughing – it’s agony. And recently I’ve been getting this sort of feeling down my right arm. It’s like a tingling feeling, I suppose. I can’t use my arm at all when it’s like that.
Doctor:	And, how long would you say that all this has been going on?
Patient:	Quite a few months. It all started when I had flu back in January, so about nine months ago, I suppose. That quickly turned into glandular fever and I was ill for a good six weeks with that. I don’t even feel like I have fully recovered now. And then, I’ve had one or two quite nasty chest infections lately and they’ve been difficult to shift.
Doctor:	Well, that’s certainly something we can look into. I see you’re a smoker. How long have you smoked, Pam?
Patient:	Well, in total, I was working this out with my husband the other day. It’s about 35 years. I know that sounds bad but it hasn’t been constant. I have quit quite a few times and it’s just that I always go back to it. I’ve always suffered from insomnia on and off anyway and giving up always makes that so bad. It means I can’t function properly because I’m so sleep deprived. One of the reasons I’d like to give up cigarettes forever though is to get my sense of smell back. You know, that went about 10 years ago. It’s amazing how much you miss it. I mean I didn’t realize how much pleasure it gave me. It affects so many different aspects of your life.
Doctor:	And as far as current medication is concerned?
Patient:	Well for about 10 years now I’ve been taking a Statin, I don’t remember what it’s called.
Doctor:	Don’t worry.
Patient:	And I’m still using my Salbutamol Inhaler. I take that everywhere I go. I find I get out of breath so easily and I do tend to panic. And I’m still on the antidepressants I was prescribed a year ago. They seem to be working really well, so I don’t want to change anything there. It’s all good apart from the obvious worry and inconvenience with this cough and everything.
Doctor:	And any allergies?
Patient:	Well, I never drink milk. It makes me throw up. And years ago, my GP diagnosed intolerance, which came as quite a relief. And I don’t know if it counts as an allergy, but hay fever always makes me really miserable. I literally can’t go outside. I just stay indoors with the windows shut and take my medicine.