Maureen Hopkins Sick Visit: Management of Endocrine Conditions Shadow health Transcript

Maureen Hopkins Sick Visit: Management of Endocrine Conditions Shadow health Transcript

Hello, I am xx. I will interview and examine you.

Patient Introduction:
Hello there.

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Question:
What brings you to the clinic today?

Patient Response:
I came in because I’ve been really tired lately. And I’ve had some hair loss. Neither of which are really normal for me.

Avatar Empathize:
I am sorry to hear this.

Patient Response:
Thank you.

Avatar Question:
When did you start feeling tired?

Patient Response:
I started feeling this tired about a month ago.

Avatar Question:
In which parts have you lost your hair?

Patient Response:
Yeah, my hair has been falling out and thinning recently.

Avatar Question:
Does resting make you feel better for fatigue?

Patient Response:
Nothing really makes it better. It feels like it lasts all day.

Avatar Empathize:
I am sorry to hear that.

Patient Response:
My hearing’s good. [AUDIO COMING SOON]

Avatar Question:
Are you taking any medication to help with the hair falling out? (Clarified to Are you on any prescription medication?)

Patient Response:
I am prescribed medication for my hypothyroidism. I take a supplement for my osteopenia, and a multivitamin, but those are over-the-counter. (Clarified to if I take any prescription medications.)

Avatar Question:
What remedies are you using to help with the hair fall out?

Patient Response:
Not every day, but more than one day a week. I’ll notice it if I’m brushing my hair, or washing it, or sometimes even just running my fingers through it. [AUDIO COMING SOON]

Avatar Question:
How is the distribution of the hair fall out? (Clarified to When do you notice your hair falling out?)

Patient Response:
Not every day, but more than one day a week. I’ll notice it if I’m brushing my hair, or washing it, or sometimes even just running my fingers through it. [AUDIO COMING SOON] (Clarified to when I notice hair loss.)

Avatar Question:
After which activities do you feel fatigued?

Avatar Question:
What aggravates your fatigue?

Patient Response:
I don’t think anything makes it worse — it’s more just a steady tiredness that lasts all day.

Avatar Question:
How has these affected your daily activities? (Clarified to How has your fatigue made it difficult to do things?)

Patient Response:
It hasn’t — I can still perform my daily activities. (Clarified to how my fatigue has made it difficult to do activities.)

Avatar Empathize:
That’s great.

Patient Response:
Thank you, dear.

Avatar Question:
What is your name?

Patient Response:
My name is Maureen Hopkins.

Avatar Question:
And have you noticed any changes with your skin?

Patient Response:
I’ve had dry skin… on my hands, arms, elbows.

Avatar Question:
Are there any other over-the-counter medications that you are using?

Patient Response:
I take a multivitamin and the calcium and vitamin D supplement — those are over-the-counter.

Avatar Question:
Do you have any other health issue?

Patient Response:
Yes, I have osteopenia and hypothyroidism.

Avatar Question:
What do you manage your hypothyroidism?

Patient Response:
It’s called Synthroid.

Avatar Question:
When did you start taking the medication?

Patient Response:
I’ve taken Synthroid since shortly after being diagnosed with hypothyroidism, around 15 years ago. [AUDIO COMING SOON]

Avatar Question:
And what dosage of Synthroid do you take? (Clarified to What dose of Synthroid are you taking?)

Patient Response:
It’s 125 micrograms, if I recall correctly. (Clarified to what dose the Synthroid is.)

Avatar Question:
And what do you use for your osteopenia? (No matching questions found.)

Avatar Question:
Have you been taking your medications as per the prescription?

Patient Response:
I always take my medications when I should. I use a pillbox, too, which helps.

Avatar Question:
When do you take the Synthroid medication? (Clarified to When do you take the Synthroid?)

Patient Response:
I take the Synthroid in the morning every day. (Clarified to when I take the Synthroid.)

Avatar Question:
Is your hypothyroidism under control? (No matching questions found.)

Avatar Question:
Are you watching your diet?

Patient Response:
I don’t have any dietary restrictions or anything like that.

Avatar Question:
Do you have any side effects with the hypothyroidism medication?

Patient Response:
No, I haven’t had any side effects from the medication.

Avatar Question:
Do you have any medication allergies?

Patient Response:
I don’t have any allergies to any medications.

Avatar Question:
Are you allergic to any food?

Patient Response:
No, I don’t have food allergies.

Avatar Question:
Tell me about your salt intake levels

Patient Response:
I haven’t been abnormally thirsty or anything like that. Just a “normal” amount of thirsty. [AUDIO COMING SOON]

Avatar Question:
And how much amount of water do you consume?

Patient Response:
I’ll usually have between 6 and 7 glasses of water a day.

Avatar Question:
Have you been urinating more frequently? (No matching questions found.)

Avatar Question:
Any specific part of your body where you particularly feel dry? (No matching questions found.)

Avatar Question:
Have you been hospitalized for hypothyroidism? (Clarified to What was your last hospitalization for?)

Patient Response:
It was years and years ago, when I gave birth to my sons. (Clarified to what my last hospitalization was for.)

Avatar Question:
Are you up-to-date with your vaccines?

Patient Response:
I believe I’m up-to-date on my immunizations, yes. [AUDIO COMING SOON]

Avatar Question:
Have you had any past surgeries?

Patient Response:
I’ve never had surgery.

Avatar Question:
Are you up-to-date with your childhood immunizations?

Patient Response:
I believe I’m up-to-date on my immunizations, yes. [AUDIO COMING SOON]

Avatar Question:
Any family history of hypothyroidism?

Patient Response:
Not that I know — I don’t believe anyone had it, or at least knew about it.

Avatar Question:
Any family history of diabetes? (Clarified to Do your family members have health problems?)

Patient Response:
The main thing was my father passed from COPD, from smoking. And my mother passed from a stroke. (Clarified to if my family members have health problems.)

Avatar Question:
On a scale of 0 to 10, can you rate your level of fatigue (No matching questions found.)

Avatar Question:
What triggers you to feel tired?

Patient Response:
I’m not sure. I can’t pinpoint any causes or anything that makes me more tired.

Avatar Question:
How long have you been feeling tired?

Patient Response:
I started feeling this tired about a month ago.

Avatar Question:
Are there any other symptoms you are experiencing?

Patient Response:
Besides losing my hair and feeling so tired… I suppose my skin has been pretty dry.

Avatar Question:
Have you experienced hair loss before? (Clarified to Have

you had hair loss in the past?)

Patient Response:
No, I haven’t had hair loss before it started 3 weeks ago. [AUDIO COMING SOON] (Clarified to if I have had hair loss in the past.)

Avatar Question:
Have you had any injuries?

Patient Question:
Have you had eye problems?

Patient Response:
My eyes and vision are fine. [AUDIO COMING SOON]

Avatar Question:
Any ear problems?

Patient Response:
My ears are doing fine. [AUDIO COMING SOON]

Avatar Question:
Have you had changes in your mouth and throat?

Patient Response:
Hm… well, I did notice a while back that my Synthroid looked different when I picked it up from the pharmacy. It was a sort of oblong pill shape, whereas it’s usually circular. And the pill bottle read “levothyroxine sodium,” instead of “Synthroid” like usual.

Avatar Question:
Have you had changes in frequency of urinating?

Patient Response:
I haven’t had any issues in the bathroom or the like. [AUDIO COMING SOON] (Clarified to if I have trouble urinating.)

Avatar Question:
Any pain when urinating? (Clarified to Do you have trouble urinating?)

Patient Response:
I haven’t had any issues in the bathroom or the like. [AUDIO COMING SOON] (Clarified to if I have trouble urinating.)

Avatar Question:
Have you notes easy bruising or bleeding? (No matching questions found.)

Avatar Question:
Do you experience pain when moving? (Clarified to Does it hurt to walk?)

Patient Response:
No, not at all. I like walking. (Clarified to if it hurts to walk.)

Avatar Question:
Have you experienced any behavioral changes? (No matching questions found.)

Avatar Question:
Have you experienced any dizziness? (No matching questions found.)

Avatar Question:
Have you had a previous blood transfusion? (No matching questions found.)

Avatar Question:
Have you had headaches?

Patient Response:
I haven’t had any headaches. [AUDIO COMING SOON]

Avatar Question:
Have you had changes in appetite?

Patient Response:
My appetite’s the same as it usually is. [AUDIO COMING SOON]

Avatar Question:
When was your last EKG screening? (Clarified to When was the last time you took any medications?)

Patient Response:
I took my Synthroid this morning. [AUDIO COMING SOON] (Clarified to when I last took medication.)

Avatar Question:
Are you having hallucinations? (No matching questions found.)

Avatar Question:
Which symptoms are associated with osteopenia? (No matching questions found.)

Avatar Question:
Any family history of thyroid issues?

Patient Response:
Not that I know — I don’t believe anyone had it, or at least knew about it.

Avatar Question:
Any family history of autoimmune disorders?

Patient Response:
The main thing was my father passed from COPD, from smoking. And my mother passed from a stroke.

Avatar Question:
Have you had all childhood and adulthood immunizations? (No matching questions found.)

Avatar Question:
Have you had all immunizations? (No matching questions found.)

Avatar Question:
Any other symptoms associated with the skin? (Clarified to Do you have other symptoms when you have palpitations?)

Patient Response:
I don’t have any palpitations. (Clarified to if I have other symptoms with my palpitations.)

Avatar Question:
How severe is your skin dryness? (Clarified to How severe is your dry skin?)

Patient Response:
My dry skin is a little uncomfortable, but nothing too bad. (Clarified to how severe my dry skin is.)

Avatar Question:
How severe is your fatigue?

Patient Response:
If I had to rate my fatigue out of 10… I’d say a 5 or 6. [AUDIO COMING SOON]

Avatar Question:
How are your menstrual patterns? (No matching questions found.)