Focused Exam: COPD Debbie OConnor Shadow Health Transcript

Started: Mar 30, 2020 | Total Time:125 min

Hello Debbie O’Connor, My name is Danielle Scott. I will be your provider today.Greet03/30/20 3:44 PMCDT
Can you verify your Name and birthday?Question03/30/20 3:44 PMCDT
I was born on October 5 . . . [Ms. O’Connor reports the correct birth year.] 
What brings you in today?Question03/30/20 3:44 PMCDT
I’m having so much trouble just trying to breathe. And I’ve had these terrible coughing fits. A few days ago, I had 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. 
I’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.Empathize03/30/20 3:47 PMCDT
That’s very kind. 
Are you experiencing any other symptoms?Question03/30/20 3:48 PMCDT
I 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. 
When did you start coughing up the phlegmQuestion03/30/20 3:50 PMCDT
I 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. 
Any aggravating factors?Question03/30/20 3:51 PMCDT
Honestly, 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. 
Is there anything that relieves the symptoms?Question03/30/20 3:52 PMCDT
Nothing 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. 
How bad are you breathing? (Clarified to How severe are your breathing problems?.)Question03/30/20 3:52 PMCDT
Breathing is so hard, all the time. I guess I’d put it at a 6 out of 10.(Clarified how severe my breathing problems are.) 
How does your health affect your social life?Question03/30/20 3:53 PMCDT
My 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. 
Do you have any other existing health conditions?Question03/30/20 3:54 PMCDT
I’ve only got Group B COPD. The chronic bronchitis kind. [AUDIO COMINGSOON] 
Any recent hospitalizations?Question03/30/20 3:55 PMCDT
I haven’t been to the hospital in about two years. I had a bad breathing episode and they said I had COPD. 
What medications are you currently taking?Question03/30/20 3:57 PMCDT
I have an inhaler that I use for my COPD — a formoterol inhaler. 
How often do you use your inhaler?Question03/30/20 3:58 PMCDT
I use it twice a day, morning and night. Every 12 hours. 
What’s the dosage of the inhaler?Question03/30/20 3:58 PMCDT
I take 12 micrograms of formoterol. 
Do you take any supplements or vitamins?Question03/30/20 3:59 PMCDT
I don’t take any vitamins or supplements or any of that stuff. 
Are you compliant with your medicine? (No matching questions found.)Question03/30/20 3:59 PMCDT
Do you miss doses of medications? (Clarified to Do you miss doses of your medication?.)Question03/30/20 4:00 PMCDT
No, I never miss doses. I use my inhaler once in the morning and once at night. I find that easy enough to remember. (Clarified if I miss doses of my medication.) 
Do you use a spirometer?Question03/30/20 4:00 PMCDT
I have a spirometer, yes. Only use it sometimes. Got an FEV1 reading of 1.37 L the other day. That’s 49%. 
Do you have any allergies?Question03/30/20 4:01 PMCDT
I don’t have any allergies, never had an allergic reaction . . . nothing like that. 
Do you use home oxygen?Question03/30/20 4:01 PMCDT
I don’t use oxygen . . . it could probably help me. But I’d blow myself up, smoking near it. 
Oxygen 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.Educate03/30/20 4:04 PMCDT
You certainly know your stuff. 
Have you had any vaccines?Question03/30/20 4:05 PMCDT
I’ve had vaccines before, but . . . it’s been a long time. 
At 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.Educate03/30/20 4:08 PMCDT
That’s good to know. 
Do you live at home alone?Question03/30/20 4:11 PMCDT
I live with my daughter, Ava. I moved in when my health started getting worse. She takes care of me. 
Do you drink alcohol?Question03/30/20 4:11 PMCDT
I don’t touch the stuff. My daddy was a drinker, and I saw what it did to him. 
Any substance abuse?Question03/30/20 4:12 PMCDT
No, that never appealed to me. 
how long have you been a smokerQuestion03/30/20 4:12 PMCDT
I 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. 
I’m sorry that you lost your husband. That sounds like it must have been very difficult for you.Empathize03/30/20 4:15 PMCDT
how many cigarettes do you smoke per dayQuestion03/30/20 4:15 PMCDT
Typically 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. 
It’s vital that you quit smoking as soon as possible in order to get some relief from your 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 quittingEducate03/30/20 4:20 PMCDT
I’ll be sure to keep that in mind. 
Do you exercise?Question03/30/20 4:20 PMCDT
I 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. 
Tell me about your diet?Question03/30/20 4:21 PMCDT
Well, 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, and salmon. 
When your 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 capacityEducate03/30/20 4:23 PMCDT
Oh! That makes sense. 
Any family history of illness?Question03/30/20 4:24 PMCDT
My 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. 
Changes in your weight? (Clarified to Has your weight changed recently?.)Question03/30/20 4:24 PMCDT
I’ve gained 30 pounds these past two years. (Clarified if I have had weight changes recently.) 
Do you have any problems with your visionQuestion03/30/20 4:26 PMCDT
I’m nearsighted, but my glasses work fine. 
have you noticed any shin issues (No matching questions found.)Question03/30/20 4:26 PMCDT