Transcript

Doctor: Ask that question yes we do we need your consent okay so thank you for consenting to let me use AI as well so let's go over the cardiology note. Patient: Yes so I got that red triangle that's what oh no so in terms of okay so in terms of the echo report that you had done. Doctor: Thanks for doing that just to examine you know do the complete the report for the high blood pressure that you've been having the only thing it showed it showed it was fine just there's like in your aorta that goes in the mild descending aorta which is in a aorta in the heart it's just mildly mildly like enlarged which can be a variation of normal it may be because you've been having the high blood pressure there's nothing we have to do about it now we just need to keep an eye on it and monitor it so we're gonna repeat the echo in two years okay and that's what the cardiologist recommended as well so I have a note in here to automatically remind us to follow up with you that in two years otherwise echo is normal no signs of heart failure other areas of enlargement thickness anything like that okay all right so then in terms of your blood pressure let's do that and then we'll finish at the very end with the I'll do the HPV test. Patient: Okay so in terms this is it's new because I had a test maybe like a year before like I got pregnant and it was clear I'm really regular with my test so I yeah I don't even understand how this appeared when I yeah haven't even changed sex partners like there's so. Doctor: Okay so I will and the good thing about doing HPV is it gives us more information the bad thing is is that leads to questions and sometimes unnecessary worry so number one for sure let alone Google does not help at all yeah surgery right no no no no so nothing like that so let me just tell you so so in terms of HPV you did a self-test which looks at HPV in the vagina in the vagina there's much more HPV than directly on the cervix so you can have HPV in the vagina but it doesn't go up the track to the cervix where it will cause issues so that's why today we have to actually check the cervix by doing a provider test I'll do it you know what you had to come back today anyways for your blood pressure check so it's all you know so if this test comes back negative the one I do we go with that okay now even if it comes back positive for HPV that does not mean cervical cancer that means that in time it may eventually lead to changes on a path that we so we have to okay that we have to keep a closer eye on usually that's what it means you very well even if with no set new sex partners you could have had HPV for a very long time years and years and years ago and not known because this is the first time we're doing HPV testing we can get HPV and sometimes the body clears it and we don't have it anymore or it just lingers around and doesn't clear and sometimes it can cause issues which is when we have to check them out okay so it's not to say this is new it's not to say that it's from any new behaviors you could have had it for a long time we're just testing for it now okay and again if it's on if it's if the cervix is clear we go with that okay so if it's not clear often especially if you've had a normal path like within the guidelines within the last like with three years ago which would have been the date of your last path likely normal exactly so even with the presence of HPV a presence of HPV with the last normal path isn't gonna three years later you're not gonna have cervical cancer so what happens is if there's an HPV test that's positive on the cervix the lab will automatically do a path test at the time to see if there's any changes on the path and that will help us guide with what next steps in all likelihood if it is positive it would just mean rather than screening you again in five years we have you come back in two years to keep a closer eye on it okay so reassurance there especially with a normal you've been really good and on top of your path test and your regular screens so that let us be more comfortable that likely it will just mean more screening if it's positive okay okay so we'll just do the regular tests and then I'll follow up if there's anything I'm okay I'll keep an eye out for it okay all right so I'm just gonna actually just make a note to myself to track it here but if you don't call me back that means it was clear it was clear you'll also get a letter in the government from that tell me that it's clear to you okay HPV I'm sending a note to myself to that result take 10 to 15 days. Patient: Yeah I'm sorry that you've been worried about it that's not the goal but these are all great questions it's just like you go then you I didn't ask you no questions right I was just like I'm yeah but you did the right you did the right thing by coming but you did the right thing by coming back and getting the regular test within three months which is the recommendation so that we can take a closer look at what's going on okay and these are all great questions that you're able to ask now all very valid questions. Doctor: Okay so I have and I also just so you know I have a reminder to myself to look make sure I get to test back and keep an eye out for it okay and if there's anything I've normal I will reach out to you okay so just keep an eye on your voicemail and the government also sends a letter they send both they send both they're supposed to any IUD in or anything like that okay now before we do that just tell me how your blood pressure at home. Patient: Oh thank you so much so Phoenix did a great job of recording these numbers are fantastic okay so yeah so you're taking the Norvax you're taking Norvax five milligrams on a daily basis. Doctor: Yeah okay and with taking the Norvax five milligrams on a daily basis your blood pressure is this one the most recent? 89 is the bottom one. Patient: This is the most recent okay but not including when you're sick? That was like five days ago. Okay. Because I've been sick. Doctor: Okay so the blood pressure is between a hundred and fourteen to a hundred and twenty systolic over 85 to 89 diastolic. Patient: Blah blah blah. You sound like Charlie Brown's teacher to me right there. I don't know what those numbers mean. All I know is I saw 80s and I was happy. Doctor: How often are you testing it at home? Patient: Twice a week like you said. Doctor: Perfect. 120s over 85 to 89. Okay so I'm happy with these numbers so that means we are going to leave you on the same dose of the medication which is the Norvax five milligrams we do not need to increase it this is working lovely for you. Have you had any side effects? Patient: No the other one gave me side effects this one nothing. Doctor: Okay remind me the other one was I'm just gonna check just so we have a note on it yeah let's see right so you were on nifidopine which caused you side effects so we switched it. Patient: Headaches, extreme headaches. Doctor: Caused you headaches yeah that can be a side effect of nifidopine but the Norvax is no side effects no headaches the headaches resolved when you stopped the nifidopine. Patient: As soon as I stopped. Doctor: Okay excellent so the Norvax you're tolerating well five milligrams we're gonna continue on that what I'm gonna do is I'm gonna give you a refill for a year okay keep checking your blood pressure you don't have to do it as often because your numbers are consistently good. Check it like every two weeks. If they start to be high again so in the 140s on the top okay see how you write the first number if your first number is in the 140s or the bottom if most of them are in the 90s just let me know. Doesn't have to be both if either or okay if you start to see most of them are in the 90s on the bottom just let me know we would just increase the Norvax. Patient: Okay okay we can like do it like twice a day or if it or like the dosage changes. Doctor: The dose would just increase by yeah exactly and it would still just be once a day. Less medications to remember to take the better okay so I don't like to do it twice a day we would just increase the amount so you'll still only take it once a day but we're not there yet I'm gonna leave it where it is now okay I'm very happy with those numbers. Patient: I'm happy I thought I was happy too. Doctor: No you're doing really well okay so we go with that. Patient: I thought I was very healthy and then I climbed on the top there. Doctor: But you know what it's really good that you came and we caught it because to be going around with high blood pressure like that that's one that leads to problems yeah blood pressure now you have great numbers yes you're taking medication likely you'll have to take the medication forever sometimes it happens after pregnancy. Patient: Okay and it runs in my family exactly so I expected it a little bit later like 48. Doctor: Okay but you know what we've caught which is the important thing you're doing a great job of taking a very small amount of medication and it's lowered your blood pressure fantastic we're good yeah yeah okay okay so do you want my number was high today right so your number is high it's always higher so if that's why we that's why we make you do the work of testing it at home it's much more accurate at home it's often higher here and I don't want to have to increase your medication if we don't actually need to because then that can lead to side effects like dizziness and so forth. Patient: Yeah yeah because you've been doing such a great job of measuring at home and your numbers are great at home we're gonna continue we're gonna go with those readings the new guideline tells those are the more important readings than it is here especially when you're sick it's good exactly so you because you've been doing such a great job of consistently taking at home and the numbers are good we're going with that keep taking at home not as often every two weeks if you start to notice it over 140 or higher or 90s or higher most of the time let me know okay otherwise we're good to go to keep doing the same thing keep setting the reminders that you've been doing because you've obviously been taking it regularly okay do you want this sent to your pharmacy shoppers on here on do you want it or do you want it printed. Doctor: Okay so it's been sent there okay so that they have it for you and you have refills for the year okay so that is done we're gonna do your let me just get set up here you can leave your top on you can leave your hat on you can leave shoes socks on just bottoms off. Patient: Okay you want to hear a true confession you're being recorded but I hope it won't be in the notes. Doctor: Yeah sure that HPV test that self-test. Patient: Yeah okay okay so the important thing is that you're here we're checking it again we'll see how it is. Doctor: Okay well thank you for letting me know that's like feedback and information for us forever and then you called me I think I have to get you again so just hang tight there I will be back in just one minute okay don't take off my clothes no I have to get you again.