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Video 5

Dr. Johnson with Virginia P. - 1 - PART 1: INTAKE
02:00:00
DR. JOHNSON: What brings you here today?
VIRGINIA P: Okay, I have an allergy and I have problems to breathe, I have phlegm in my
chest. And I have a lot of cough. When I cough I felt a lot of pain in my bones. And that’s why I came. I came last year with this problem. I had problem.I had problems to read at night when I go to bed. And I need help. I.I try a lot of medicines for allergy, like Benadryl, a lot. 02:00:33
DR. JOHNSON: What.what have you tried?
VIRGINIA P: Nothing more. Benadryl, I tried what, Zyrtec, the (INAUD) medicine for allergy.
I tried.the medicine in the little blue.blue box, I don’t know. DR. JOHNSON: For allergies also.
VIRGINIA P: Yeah.
DR. JOHNSON: And that didn’t help.
VIRGINIA P: Nothing helps.
DR. JOHNSON: Do you have a history of asthma?
VIRGINIA P: Uh, last year when I came, a doctor said that I had asthma.
DR. JOHNSON: Okay.
02:00:57
VIRGINIA P: But I don’t know. If I my inhaler to (INAUD) me, but just when I need.when I
need it. And if when I.when I use, I feel my heart here in my mouth, cause like tachy. DR. JOHNSON: Tachycardia and it’s a very common symptom with it because albuterol really
ups your heart rate, it makes it a lot faster. So that’s a very common complaint. How often do you VIRGINIA P: At night, at night, yeah.
DR. JOHNSON: Do you use it every.every night?
VIRGINIA P: Not every night. When I feel that I really need it, I don’t want to use it if.just
have a sit on my bed and try to relax. And I don’t want to use it because I’m scared, I’m really Dr. Johnson with Virginia P. - 2 - 02:01:37
DR. JOHNSON: Okay, okay. How often have you had to use it on average? On.for example
for the past month, how many times have you used it would you say? VIRGINIA P: Past month I didn’t use it. But uh, when.I start to use it I have to use it in one
DR. JOHNSON: Okay. So your main complaint today is really just allergies here. Sneezing.
VIRGINIA P: Sneezing. My.itch in my ears, my eyes, my throat.
DR. JOHNSON: Okay, any fevers that you felt?
VIRGINIA P: No, no fever. And also I feel my chest compress.
DR. JOHNSON: Okay.
VIRGINIA P: And this phlegm doesn’t go out.
DR. JOHNSON: So you are having some coughing also?
VIRGINIA P: Yeah, a lot of coughing, yeah.
02:02:17
DR. JOHNSON: Okay. And the coughing is worse at night or in the daytime or all the time?
VIRGINIA P: Oh at night.
DR. JOHNSON: Do you produce phlegm when you cough at night?
VIRGINIA P: The beginning, yes.
DR. JOHNSON: Yeah.
VIRGINIA P: But now I feel.I feel this but I don’t have any phlegm out.
DR. JOHNSON: Okay. Any other complaints today?
VIRGINIA P: No.
DR. JOHNSON: Okay, just that.
VIRGINIA P: That and the pain that (INAUD) in my ribs.
DR. JOHNSON: Okay, so I’m going to take a quick listen to you just to make sure there’s no
evidence of a pneumonia or a bronchitis going on. VIRGINIA P: Okay.
Dr. Johnson with Virginia P. - 3 - DR. JOHNSON: And then do an exam of the face just to see what’s going on congestion-wise.
But definitely this season is the popular time for seasonal allergies and it sounds like you’re having a component of that and possibly some.some lung involvement with that. So we’ll get you the medications you need. Do you have any allergies to any medications that you know of? VIRGINIA P: No, no.
02:03:06
DR. JOHNSON: Okay. Do you smoke?
VIRGINIA P: Yeah.
DR. JOHNSON: Okay. How.
VIRGINIA P: I quit.
DR. JOHNSON: You quit.
VIRGINIA P: Yeah.
DR. JOHNSON: When did you.when did you quit?
VIRGINIA P: Yesterday.
DR. JOHNSON: (LAUGHS) Well congratulations.
VIRGINIA P: Thank you.
02:03:15
DR. JOHNSON: But in all.I mean in all seriousness, with asthma or any of these rhinitis, I mean
smoking is just so much worse for it. When.when other people walk around smoking, it doesn’t affect; with you it’s.it’s sort of more of an allergen. It really irritates the system, so. VIRGINIA P: Yeah. I was trying to quit like three months ago and I was smoking like one-two
DR. JOHNSON: Okay.
VIRGINIA P: And then yesterday I decided because I feel so bad.
DR. JOHNSON: Just to stop.
VIRGINIA P: Yeah.
02:03:43
DR. JOHNSON: If you are having problems stopping that you find in the future, talk to your
regular doctor, Dr. Zabar about that because there are things we have to help people to stay off of Dr. Johnson with Virginia P. - 4 - VIRGINIA P: Okay, right.
DR. JOHNSON: Do you take any other medications other than the ones you just told me, other
VIRGINIA P: Not allergy medication.medication, but I took Robitussin for congestion and it
DR. JOHNSON: Okay.
PART 2: EXAMINATION
02:04:14
DR. JOHNSON: Okay, I’m going to do the exam now. I’m going to have you sit up here. What
VIRGINIA P: I’m a manager in a restaurant.
DR. JOHNSON: Okay. The other things with seasonal allergies you know we talked about the
smoking, but is just to keep an eye also on things that you’re exposed to. For a lot of people that’s a lot of dust, but this season, it’s because of a pollen for a lot of people. But just to keep an eye around where you work and especially at home where you have more control over the amount of dust or also pet dander. So if you have cats or dogs. VIRGINIA P: I have cats.
DR. JOHNSON: Okay.
VIRGINIA P: Yeah.
02:04:53
DR. JOHNSON: So I mean you probably are more used to.accustomed to.cause they’re your
own cats, but just keep an eye on that, watch to see if you have more contact with them for having more of these symptoms, cause that’s very common. VIRGINIA P: Yeah. Yeah, well.
DR. JOHNSON: Have you noticed?
VIRGINIA P: No, I never. Yeah. I always had animals at home, like cats, dogs, horses and a
DR. JOHNSON: Okay.
Dr. Johnson with Virginia P. - 5 - VIRGINIA P: When I was a child I had a lot of animals.
02:05:15
DR. JOHNSON: Okay, just keep the area around home as clean and out of dust as possible cause
that will help with your symptoms too. Okay. Look straight ahead for me. And you told me about the itchy eyes. Are you having tearing of the eyes also, like watery.watery discharge? VIRGINIA P: No.
02:05:37
DR. JOHNSON: Okay. Okay. Your mouth open, say a big aah. Stick your tongue out,
excellent. I’m just going to put some pressure on your face, any pain when I do that? Or here? VIRGINIA P: No.
DR. JOHNSON: Not much. No pain in the neck area.
DR. JOHNSON: Uh-uh.
DR. JOHNSON: Not much.
DR. JOHNSON: Let me take a look in the nose for a second, okay. And it’s mostly congestion
you have in the nose, or is it mostly runny nose, or is it a combination of both you would say? VIRGINIA P: It’s a combination.
DR. JOHNSON: It is a combination.
VIRGINIA P: Yes.
DR. JOHNSON: Okay.
VIRGINIA P: And one.for example, when I feel itch in my ears, I know that my throat is going
DR. JOHNSON: Um hmm, it’s all connected.
VIRGINIA P: Yeah.
02:06:28
DR. JOHNSON: Okay. Take a listen to your lungs. Mouth open, deep breath in and out. Again.
02:07:20
Excellent. Okay, so no pneumonia in the lungs. However there is.I can hear some of the inflammation in the there and a little bit of wheezing. So you definitely have a broncho.your Dr. Johnson with Virginia P. - 6 - bronchials, the airway tree are definitely inflamed and that’s probably due to the, like we said, the allergic reaction you’re having, plus a little bit of your asthma.

Source: http://bravewell.org/videos/files/transcript_12_Video%205.pdf

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