TRANSCRIBED FILE

Speaker 1 [00:00:11] Hello, Mrs. Hanson! I'm Dr. Hudson.

Speaker 2 [00:00:13] Hello!

Speaker 1 [00:00:14]: I understand you're having some pain.

Speaker 2 [00:00:15]: Oh yes, I have a stomach pain.

Speaker 1 [00:00:18]: Yes. When did it start?

Speaker 2 [00:00:19]: Last night.

Speaker 1 [00:00:20]: Last night, about what time?

Speaker 2 [00:00:22]: 9:00.

Speaker 1 [00:00:23]: 9:00.

Speaker 2 [00:00:23]: Yeah.

Speaker 1 [00:00:24]: Where was it when it first started?

Speaker 2 [00:00:25]: It was kind of generalized.

Speaker 1 [00:00:27]: All around?

Speaker 2 [00:00:27]: Yeah.

Speaker 1 [00:00:28]: Okay.

Speaker 1 [00:00:29]: Did it change at all?

Speaker 2 [00:00:30]: Yeah.

Speaker 1 [00:00:31]: Where? How did it change?

Speaker 2 [00:00:32]: Now, this morning, when I woke up it was more central.

Speaker 1 [00:00:34]: Okay.

Speaker 2 [00:00:36]: I know. It’s more here.

Speaker 1 [00:00:38]: On the right side. What kind of pain is it?

Speaker 2 [00:00:43]: It's really, right there.

Speaker 1 [00:00:45]: Okay.

Speaker 2 [00:00:48]: And it’s constant.

Speaker 1 [00:00:48]: It's constant. Is it like a grabbing pain? A stabbing pain? A dull ache?

Speaker 2 [00:00:55]: Dull ache.

Speaker 1 [00:00:57]: A dull ache. Is it going around the back at all, down in the groin area?

Speaker 2 [00:01:00]: No.

Speaker 1 [00:01:02]: It's just right there now?

Speaker 2 [00:01:03]: Yeah.

Speaker 1 [00:01:03]: But it started more generalized?

Speaker 2 [00:01:04]: Yeah.

Speaker 1 [00:01:06]: On a scale of one to ten, last night, how bad was the pain?

Speaker 2 [00:01:09]: I would say-- a two.

Speaker 1 [00:01:11]: A two. And now, what would you say?

Speaker 2 [00:01:12]: Oh, seven!

Speaker 1 [00:01:13]: A seven, okay. When it first started, were you doing anything in particular?
Did you lift something heavy?

Speaker 2 [00:01:19]: I was just--

Speaker 1 [00:01:21]: Did you twist? Was there any trauma?

Speaker 2 [00:01:22]: –I was just looking at the TV.

Speaker 1 [00:01:25]: Okay. All right. Through the night, did it wake you up?

Speaker 2 [00:01:28]: No, I slept.

Speaker 1 [00:01:29]: You were able to sleep?

Speaker 2 [00:01:30]: Yeah.

Speaker 1 [00:01:31]: Okay. Do you feel nauseated?

Speaker 2 [00:01:32]: This morning.

Speaker 1 [00:01:33]: This morning. Did you throw up?

Speaker 2 [00:01:34]: Yeah, like an hour ago.

Speaker 1 [00:01:37]: An hour ago. How’s your appetite? Do you feel hungry? Do you want to
eat?

Speaker 2 [00:01:38]: No.

Speaker 1 [00:01:39]: You don't. Okay. Did you have any fever?

Speaker 2 [00:01:45]: I did not take it, but now I feel kind of feverish.

Speaker 1 [00:01:51]: You feel a bit feverish. Did you have any night sweats last night?

Speaker 2 [00:01:55]: No.

Speaker 1 [00:01:56]: No, or chills where you were shaking?

Speaker 2 [00:01:57]: No, but this morning, it’s about to get started.

Speaker 1 [00:02:02]: Okay. Tell me about your bowel movements. When was the last one?

Speaker 2 [00:02:06]: Yesterday morning.

Speaker 1 [00:02:07]: Okay. Was it normal?

Speaker 2 [00:02:08]: Yeah.

Speaker 1 [00:02:10]: Did you have a period of time in the last week or so where you were
either constipated or had diarrhea?

Speaker 2 [00:02:15]: No.

Speaker 1 [00:02:16]: Have you recently noticed any blood in your stools?
Speaker 2 [00:02:18]: No.

Speaker 1 [00:02:19]: Or any black, tarry stool?

Speaker 2 [00:02:21]: No.

Speaker 1 [00:02:22]: No. Are you having problems with your bladder in terms of burning when
you urinate or having to get up at night to urinate?

Speaker 2 [00:02:27]: No.

Speaker 1 [00:02:28]: No. Have you seen any blood in your urine?

Speaker 2 [00:02:31]: No.

Speaker 1 [00:02:32]: No. Okay. Tell me about your period. So, do you still menstruate?

Speaker 2 [00:02:35]: No. It stopped five years ago.

Speaker 1 [00:02:38]: Five years ago. Okay. Alright. And you haven't had any spotting or
bleeding at all?

Speaker 2 [00:02:39]: No.

Speaker 1 [00:02:46]: And are you sexually active?

Speaker 2 [00:02:48]: Not for the last six months.

Speaker 1 [00:02:50]: No new partners for the last six months. Okay. Alright. Have you ever had
any problems with this kind of pain before?

Speaker 2 [00:02:57]: No.

Speaker 1 [00:02:58]: Similar pain?

Speaker 2 [00:02:59]: No.

Speaker 1 [00:03:00]: This is the first time. Tell me about your health. Do you have any other
medical problems?

Speaker 2 [00:03:05]: No.

Speaker 1 [00:03:05]: High blood pressure? Cholesterol problems? Heart problems?

Speaker 2 [00:03:07]: No.

Speaker 1 [00:03:08]: Do you take medications?

Speaker 2 [00:03:12]: Just homeopathic. Only homeopathic ones.

Speaker 1 [00:03:16]: Okay. Which ones are those?

Speaker 2 [00:03:16]: Primrose. I'm sorry. I take selenium, and I take vitamin C and A, and
Primrose tablets.

Speaker 1 [00:03:27]: Primrose tablets. Okay. Do you take any aspirin at all?

Speaker 2 [00:03:30]: No.

Speaker 1 [00:03:30]: Any Advil or Ibuprofen?

Speaker 2 [00:03:33]: No.

Speaker 1 [00:03:35]: Okay. Do you have allergies to medications?

Speaker 2 [00:03:36]: No.

Speaker 1 [00:03:37]: Have you ever had surgery before?

Speaker 2 [00:03:38]: No.

Speaker 1 [00:03:39]: So, you don't know if you have any issues regarding general anesthetic?

Speaker 2 [00:03:44]: No.

Speaker 1 [00:03:45]: No problems like that. Family history in particular of bleeding tendencies
or blood clot problems?

Speaker 2 [00:03:54]: No.

Speaker 1 [00:03:55]: Okay. Have you ever had kidney infections or bladder infections?

Speaker 2 [00:03:58] Never.

Speaker 1 [00:03:59] No. Alright. Okay. So, I'm going to examine you. Okay? So, if you want to bring your
legs down here. Just bring them down gently. I know it's going to hurt a little bit. Yeah. Okay and now, I'm
going to just have a look at your abdomen. Okay? So, we're going to just expose here and I'm going to
look to see if your abdomen is distended. Do you feel bloated at all with your belly all swollen up?
Speaker 2 [00:04:24] No.

Speaker 1 [00:04:23] Okay. So, it looks good. I don't see any swelling of your abdomen or any bulging
anywhere. So, now I'm going to give little taps, okay? So, show me the area where you're sore.

Speaker 2 [00:04:38] Here.

Speaker 1 [00:04:39] Okay. So, we're going to save that spot for last. So, I'm just going to give little punches
here. Does that hurt you a bit?

Speaker 2 [00:04:46] Yeah.

Speaker 1 [00:04:50] Okay. Now, I'm just going to lightly palpate just on the top like that. That's all, okay?
How about down here? It hurts a bit. Okay. Now, I'm going to go deeper down. Okay. That's okay there?
And if I press here, do you feel it a bit? Where do you feel that when I'm pressing here? So, you feel it on
that side. Okay. And now I'm going to go deeper here. Okay. So, I do see that your muscles are tensing up
when I’m doing that. Okay. I'm going to do another test, where I'm going to press down and I'm going to let
go. Okay? So, you tell me if it hurts so I'm going to press down. I know it hurts here. I'm going to let go.
Okay. That does hurt. I'm going to do it on this side too. I'm going to press down. I’m going to let go. That
really hurts, okay.

Sorry about that. Now, I'm going to listen for your bowel sounds. Okay. I should have done this before
palpating you but let me have a listen here. Okay? So, I'm just going to listen in all four quadrants, in all
areas of the abdomen. Very good. Your bowel sounds are okay. So, we see that the gases are going
through, that there's no blockage there. Okay? So, now I'm going to ask you to lift up your leg. Okay? And
keep it up. So, well, let's bring your leg out of the blanket. It will make it easier for you to just bring it up in
the air like that and just don't let me push your leg down. You tell me if it hurts. That does hurt. Okay! Alright.
So, let's bring these down. Okay. And now I'm just going to be pressing a little bit on your kidneys back here.
Does that hurt you? Okay. How about on this side? Does that hurt you? That's good, very good. Now, I'm
going to want to have a little bit of an examination to look at your tubes and your ovaries. We'll call a
gynecological examination.

Speaker 3 [00:06:56] Exam is normal.

Speaker 1 [00:06:59] Very good! And another thing that we need to do is do a rectal examination that's to
put a finger in and feel the area where—

Speaker 3 [00:07:04] Those examination is normal as well.

Speaker 1 [00:07:05] It is normal. Okay, very good! So that concludes--

Speaker 3 [00:07:10] I have a question for you. What's your diagnosis?

Speaker 1 [00:07:19] Well, my principal diagnosis is appendicitis at this point. [END 00:07:25]