NR 579 iHuman Week 3 HPI: Asher Wilson 74 y/o NR 579 iHuman Week 3 HPI: Asher Wilson 74 y/o NR 579 iHuman Week 3 HPI: Asher Wilson 74 y/o

NR-579 iHuman Week 3 iHuman HPI-Asher Wilson 74 y/o Mflu-graded A-2022-2024

NR 579

iHuman Week 3

HPI:

Asher Wilson

74 y/o M

Has had the flu shot

Good Questions:

How can I help you today?

• I haven’t been feeling up to par lately; perhaps all together for 2 or 3 months, now. I’m fatigued

and I have no physical energy. I figured it was time to have it checked out.

Do you have any other symptoms or concerns we should discuss?

• I get short of breath every time I walk even a short distance or climb as few as 10 stairs. I have to

stop and rest and catch my breath. I’ve also had a dry cough when I lie down in bed—but that’s

only been since I had a cold 3 weeks ago.

Have you been having fevers?

• Not now. Maybe a low-grade temperature with the cold a few weeks back, but not chills.

Have you noticed any swelling in any part of your body?

• A year ago, by the end of the day there was definite puffiness of my ankles and shins, and

sometimes in my feet, but it typically resolved overnight. But it’s definitely worse and doesn’t

seem to get better by the morning. Other than that, no other swelling.

Do you sleep with pillows to help you breath?

• Yes. I use 3 and sometimesthat isn’t enough so I get up to sleep in the recliner.

Can you tell me about any current or past medical problems you have had?

• I’m in reasonable health for a fellow my age. I’ve been treated for high blood pressure over the

last, say 6 or 7 years. And I was checked out for chest pain during that same time. They said I

have CAD, but fortunately it never progressed to me needing any intervention. In fact, I only

rarely have chest pain. And to be thorough, I should add that I have what they call “wear and

tear” arthritis of my neck, and also an old man’s prostate-neither getting any worse; just

annoyances.

Are you taking any prescription medications?

• Not at present. Istopped my blood pressure medication about 5 or 6 weeks ago. A friend said

that those pills can cause fatigue, plus I think I was peeing too much. I’ve been on them for a

long time, but I thought I’d just give it a try not taking them to see if that would help. Hasn’t

seem to. Maybe I should go back on them again what do you think?

Are you taking any OTC or herbal medications?

• Just one of those “senior” multivitamins each day. My wife insists on it.

Are your immunizations up to date?

• Absolutely…a cheap ounce of prevention.

Do you drink alcohol? If so, what do you drink and how many drinks per day?

• I’m a creature of habit: 1 glass of wine with dinner; 1 shot of scotch before bed.

Do you now or have you ever smoked or chewed tobacco?

• No, not currently. I did smoke cigarettes for about 25 years as a young man-no more than a pack

and a half per day. It’s been a very long time since I quit that nasty habit.

Can you tell me about your diet? What do you normally eat?

• My wife is an excellent cook and still enjoys it. With my high blood pressure she’s a real stickler

for keeping our diet healthy. I do like a steak now and then though.

Do you have any problems with headaches that don’t go away with aspirin or Tylenol (acetaminophen),

double or blurred vision, difficulty with night vision, problems hearing, ear pain, sinus problems, chronic

sore throats, or difficulty swallowing?

• Such a long list of things you seem to be worried about. If I remember everything you asked…

none of that.

Do you have any problems with nausea, vomiting, constipation, diarrhea, coffee grounds in your vomit,

dark tarry stool, bright red blood in your bowel movements, early satiety, or bloating

• Blood? Good gracious no! No nausea or throwing up either. Is that it?

When you urinate, have you noticed any pain, burning, blood, difficulty starting orstopping, dribbling,

incontinence, urgency during day or night, or any changes in frequency?

• Well, I have old man’s prostate, but that’s not new and not why I’m here today.

Do you have problems with muscle or joint pain, redness, swelling, muscle cramps, joint stiffness, joint

swelling or redness, back pain, neck or shoulder pain, or hip pain?

• Just the arthritis I’ve had in my neck for years, but I don’t think that is related to why I’m feeling

so tired lately.

Do you have problems with heat or cold intolerance, increased thirst, increased sweating, frequent

urination, or change in appetite?