Utterance
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D_ACT
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Okay, thank you, doctor.
2gt
Pleasure. All right.
2gt
Bye bye.
2gt
Hi, Miss Jones.
2gt
Yes
2gt
I'm Jane Corona. I'm a medical student with university here
2gt
Nice to meet you
2gt
I've been sitting by Dr. Smith is part of our treating as a medical student to do an interview with you. Okay. And then I'll take that information back to Dr. Smith And then she will come back in and see you then after that
2gt
okay.
2gt
All right. How may I address you?
1irq
Mrs. Jones is fine.
0id
All right. Thank you. Um, is that okay with you today to talk?
5yq
Yes. Okay, fine, thank you.
7ack
I'm going to start out today by just talking a little bit with you about your chief complaint What brings you here today?
1irq
Sure, my left elbow is actually been bugging me a lot. Every once in a while, I've been getting a little bit of pain, extending my arm and going back to bending it. Really, that's the primary reason I've come in I've attempted to take a little bit To Tylenol to relieve the pain but it's not really seemed to help much.
0id
Okay, before we talk a little bit more about that, is there anything else that you want to talk with either me or Dr. Smith today?
5yq
Not that I can think of no.
9on
Okay. Tell me more about this pain.
1irq
Um, it's just kind of a throbbing pain, it'll act up kind of randomly throughout the day. It doesn't it's not specific to, you know, the morning or evening, or even in the middle of the day or night. It just kind of randomly acts up. I would say excessively, like when I'm doing work, like after the dishes will start to act up. If I, you know, lift one of my children up, it'll start to act up. So any sort of exertion is kind of where I've noticed a lot of the pain coming from
0id
and tell me when did it start for you?
1irq
I would send every about maybe a week and a half to two weeks ago.
0id
And you describe the pain is throbbing. Is there anything else about the pain in terms of the quality of the pain that you want to describe for me?
5yq
No Just really throbbing
9on
okay, started about a week to two weeks ago. Okay. And do you recall what you were doing at the time that it started?
5yq
I've been helping my husband clean out the garage lately, and we were lifting some boxes. And that's kind of I didn't notice it at the moment, but later in the evening, started to act up.
0id
Okay. Umm I would like to hear about a little bit about the severity of it on a pain scale of one to 10, 10 being the worst pain you've ever had one or zero being no pain at this, How bad is this pain?
1irq
I would measure it probably six or seven. It's become more of a nuisance than an actual physical pain.
0id
Okay. And is it a six or seven all the time?
5yq
Um, whenever it starts to act up, yes.
0id
Okay. And how often a day does that happen?
1irq
I would say maybe two to three times per day.
0id
Do you notice any pattern to that at all?
5yq
No.
9on
Okay. All righty. And can you point exactly to Where it is for me the location exactly?
1irq
Kind of the area that just kind of wraps around the actual elbow than it is really bothering me.
0id
And does that pain go up your arm or down your arm or anywhere else on your arm?
5yq
No It stays right in that area.
0id
Is there anything else that goes on at the same time? Any other symptoms that happen anything else other than when the pain is happening there anything else going on for you?
5yq
Not that I've noticed, No.
9on
Is there anything that makes it feel better?
5yq
Um, nothing that completely gets rid of it. I will relieve it for a temporary period of time. But it hasn't gotten rid of it.
0id
And how much time it will do take?
1irq
I whatever it says on the bottle usually wanted to tablet
0id
is that regular strength or extra strength?
5yq
regular strength.
8op
You just take it across the counter to normal directions on the bottom.
4crq
correct
6cd
Okay. And does anything make it worse?
5yq
Um, like you mentioned any sort of exertion, picking up a child doing the dishes, pretty much daily kind of living.
0id
So using it.
4crq
Yes.
7ack
Have you seen anybody else for this complaint?
5yq
Um, no.
9on
Have you What else have you tried other than the Tylenol and anything else?
1irq
Um, I've attempted to use a heating pad on it. And I've also attempted ice. Neither were successful.
0id
Okay. It sounds you've talked a little bit about how it's impacted, you know, you to be able to work in the garage or do the dishes or lift your child is there Other impact on your life,
4crq
Umm like I mentioned is more of a nuisance. There'll be times in the middle of the night that will start to act up. If I get up to go to the bathroom. I'll notice pain in my elbow.
6cd
Does it wake you up at night?
5yq
It doesn't, but if I wake up in the middle of the night Well, trouble me and falling back asleep.
9on
Okay. What do you think it is?
1irq
Um, I'm not quite sure my best guess is maybe some sort of pulled muscle or something. But I honestly don't know.
0id
All right. What I'd like to do now is just kind of go through all the things that you told me and summarize for you. This is information that I want to take that but I want to make sure that I have it all correct. So if I've forgotten something, or I've gotten something incorrect, please, please help me.
0id
Okay.
7ack
You came to the clinic today for a complaint of left elbow pain, and it's pain that you mostly noticed when you were bending it or using it in some capacity. It's a throbbing pain that happens randomly, but it does happen two to three times during the day, which you notice about is if you exert or you extend or flex your elbow at all, that's when it seems to be at its worst. It's gone on for about a week, maybe two, two weeks when you think back on it, and it started out when you were helping your husband clean the garage and you were lifting locks of boxes. So about a six to seven on a pain scale. And you describe it over and over as being a nuisance, which tells me that it's getting kind of in the way of doing some things that you want to you report that it happens probably two to three times a day, and that the pain wraps around the joint. Completely, you've taken some Tylenol for it across the counter, you've taken that several times a day now with without much relief
0id
right
7ack
I'm not that I can think of no.
9on
Thank you for telling me about your chief concerns. So I'm going to take it back to Dr. Smith.
2gt
Thank you very much.
2gt
Erica, how you doing today?
2gt
Good. Thank you.
2gt
You're doing good?
1irq
between part of me that wants to settle down, but then part of me that also wants to pursue my career and what I'm doing
0id
so we have a part that wants to settle down, a part that wants to keep going with the career so For this to chair, what I like to do is in the chair where you're seated now, this will be the emotional self, in this case, the side that wants to pursue the career. Yeah, myself before that seems like we're more that's what I really want. Yes, you're more emotionally connected. That's what you want. That's what I want. So this will be the side of you, that has the needs and the wants, and more the emotion. Okay, so that's who you'll be in this chair. That makes sense.
5yq
Yep.
7ack
In the other chair, let's have the critic that's inside that internal critic. That's advocating for settling down for getting married for having kids. In a way it represents a societal pressure Did those two sides seem separate to you?
5yq
Yeah.
7ack
You feel like you can be the emotional self here, an internal critic there?
5yq
I think so. Okay.
8op
So, I think you remember how this work she'll be, he'll be talking to this case the internal critic, right? So the internal critics on the side of settling down, getting married. And then when you're ready to have the critic respond, you'll switch that chair and respond to the emotional needs driven and wanting some make sense. Okay. So whenever you're ready, go ahead and speak directly to the internal critic.
1irq
I want to Finish what I'm doing, and I want to finish what I started. I've worked so hard on my career path, and I'm so close to finishing. And I want to finish for me want to accomplish those goals that I've set for myself? And something I'm passionate about?
0id
So you've made your statement. Are you ready to switch? Okay, good switch. So I use the internal critic.
1irq
There's always time to pursue a career, but I need to focus on what's expected of me at this time, on the best age for having kids I have a loving boyfriend who is ready and wants to get married and settle down. And you are being selfish by just following a path that you can take at any time
0id
an internal critic cues in the emotional side, in this case, the career side, been selfish. And notice your posture is very linear and you're upright. I noticed you kind of put your hand down a little bit when you're talking. Try to think of the internal critics, body movements. Try to act that out a little bit. Okay.
1irq
Think it's accusation. You know, I think I like I just wanted to, like tell the emotional part that it's being stupid that it's, you know, you're you're you're not acting in the best interest of everyone else. Jump at it.
0id
You're gonna jump at the emotional side?
5yq
Yeah.
7ack
So that's the internal critic, they respond back to the term critic from the emotional side.
3gc
Yeah,
3gc
okay. So the internal critic is just called a selfish and one of the things is a response.
11orq
I feel like I'm being attacked. And I don't think it's wrong to think about myself and what I am truly passionate about.
10od
Let me interrupt you. So your hands are pointing back toward the career emotional self. What can you do with your hands that really embody that you want to communicate to the internal critic? Is there anything else you want to do?
4crq
the pointing towards me to protect myself from what the critics is saying. I just want to like push that back towards critic.
6cd
So continueand have used that motion there. You're, you're pushing the internal critic away. Okay.
4crq
So I don't need I don't need to feel guilty you know, I don't need to feel selfish for wanting to follow my dreams
6cd
does the internal critic have something to say back?
5yq
No.
9on
So you've you've now pushed the emotional side is pushed the critical way.
4crq
Okay. I think the critic, the critic feels like it understands where the emotional side of me is coming from. You know, like I can recognize why it's so important, then, like why working so hard is, is worth that, you know, sense of accomplishment that's going to come with it, how it's gonna, in the long run, help provide for all these extra things that I want to like my family in the future. I can see that.
6cd
Alright, so internal critic is that hands down here is the internal critic. Right? It's an internal critic less angry, less assertive,
1irq
less pushy, less pushy, less pushy. Yeah, it's not. Not as critical. Truthfully, it's just I feel like the the pressure is annoying Dwayne on either either shoulders
0id