Effective Communication

0:04hello hello hi my name is Jun Smith uh

0:08I'm a medical student at

0:10rcsi um I have down here that your name

0:13is an Maguire is that correct do you

0:15mind if I call you an not all okay and

0:18it says here that you're 36 I am correct

0:21okay wonderful um and could you tell me

0:24a little bit about what brought you in

0:26here today basically I've been getting

0:28headaches I'm worried about them um I

0:32have been getting them on and off for

0:34about 2 months but of late I'm getting

0:37them about three times a

0:39week okay so started off so it's been

0:42about two months and you're getting them

0:46three times a week

0:47now okay and how often were you getting

0:50them in the beginning sply I probably

0:53would get one of four nice but now

0:56they're much more frequent okay tell me

0:59a little bit more about the headaches so

1:01basically I I can have a pain here or a

1:04pain at the back of my head when I wake

1:07up in the morning so it's either or

1:10either or okay does it radiate anywhere

1:12else no it's either just to the front of

1:16my head or sometimes when I wake up like

1:18I wake up with a pain at the back of my

1:20head okay could you tell me a little bit

1:24about how severe the headaches are let

1:26me give you a scale so if 10 was the

1:28worst headache You' ever had had in your

1:30life and one was barely anything at all

1:34where would you be on that scale at the

1:36moment originally they probably were one

1:39or two I wouldn't pass any heat you know

1:41um they would be there I'd be aware of

1:43it but I'd get on with work okay but

1:45lately they're probably an ace I okay

1:50all right okay could you tell me are

1:52there any other um things that seem to

1:54come on when you have the

1:58headaches watch by that do you get any

2:01other uh feelings do you for example

2:04feel a little bit

2:05nauseated I do sometimes I do and I have

2:09vited a few times when the pain is very

2:12bad okay all right uh any other things

2:15that will warn you maybe that uh the

2:18headache is coming on

2:20not some people notice the sort of

2:24visual changes zigzags or spots in their

2:27eyes anything like that I have a no

2:29system myal okay all right uh have you

2:33ever found yourself um dizzy during one

2:37of these headaches I have actually and I

2:40suppose with the modern medicine I have

2:43been Googling that and that's something

2:45that's made me quite worried that's one

2:47of the reasons why I came I read a link

2:50that this could be associated with

2:53Ms I see it it can be very worrying when

2:57you get a headache like this and uh but

3:00I'll tell you what we'll continue on

3:02we'll get to the bottom of uh exactly

3:04what's going on and I'll speak with my

3:07supervisor afterwards and we'll we'll

3:09figure out what we'll get to the bottom

3:11of it for you okay let's just find out a

3:13little bit more about what's going on so

3:16um let me just summarize what we know to

3:19this point so the headaches have been

3:21going on about two months getting more

3:24frequent now they're about three times a

3:26week they're run eight on 10

3:29occasionally had vomiting nothing warns

3:31you about them does anything make them a

3:35little bit uh better anything relieve

3:37them paral used to help and now I need

3:40to take paral and neuropen and that does

3:43take the edge off but I still would have

3:46some pain but it would probably take it

3:48from an eight down to maybe a three or

3:51four okay okay um is there anything that

3:56you think makes them worse anything that

3:58brings them on worse times when I'm

4:00tired they can be worse okay or if I'm

4:03particularly stressed they can be worse

4:06okay okay uh now has anything uh

4:10happened to give you concern like You'

4:13had an episode where you've collapsed or

4:18uh you think you might have lost

4:20Consciousness around the time of the

4:21headache never had any uh arms or legs

4:25twitching or anything like that my

4:27thought okay all right okay okay I'm

4:30just going to move ahead now and just

4:32ask you a few questions about your past

4:33history okay uh have you had any other

4:36medical problems no okay and have you

4:40had surgery of any kind I had my adids

4:43removed as a child okay all right um

4:48I'll just write that down there so I

4:50don't forget okay um medication wise

4:54you've taken the paracetamol and the

4:55nurin are there any other medications

4:57you're taking on no okay

5:00all right just a few more questions now

5:02about your family has anybody had in

5:05your family any medical problems at all

5:07no my parents are both alive and well

5:10and I'm know the child okay all right

5:14I'm just going to ask you a few

5:16questions about your home life just to

5:18get a sense of how things are there uh

5:20are you living alone or with anybody I

5:22live with my husband with your husband

5:24okay great I'm my daugh don't forget her

5:27she's important she very important yes

5:30so the three of us live together okay uh

5:34and are you working at the moment I am I

5:36work in the bank okay and how is that

5:39are you having any difficulties at work

5:41no it's fine okay are the headaches

5:44impacting your ability to get to work or

5:46anything I have been late on occasion

5:49sometimes I wake up with the headaches

5:50and that makes me late for work okay but

5:53I happen to miss days due to the

5:54headaches okay all right um now uh I

5:59have have to ask this for all my

6:01patients have you had are you a smoker

6:03at all I am you are okay and how much do

6:07you smoke I smoke about 10 10 a day 10 a

6:10day and how long how long do you think

6:13probably about 10 years about 10 years

6:16okay and do you take any alcohol during

6:19the week no none at all okay all right I

6:23I have to also ask this to my patients

6:25do you take any recreational drugs at

6:28all I did forget to ask you one thing

6:31about the your medications beforehand uh

6:34do you take any other over-the-counter

6:36medications or any herble medications I

6:38don't no and have you allergies to any

6:41medications still no okay right okay so

6:45I think I have a pretty good idea of the

6:48headaches uh that have been concerning

6:50you is there anything else that I have

6:53forgotten uh to ask you anything else

6:55that you would like to tell me uh I

6:59smoke

7:00my main concern really was the fact that

7:01they're more frequent than they have

7:03been and then when I read about the

7:06causes of headaches that has frightened

7:08me yes and Ms I suppose would be

7:11something that I would be um I was

7:14afraid of getting I don't know if

7:17headaches would be a sign that you could

7:19have MS it would be uh

7:22unlikely um but I'll tell you what what

7:24I'm going to do is I'm going to speak to

7:26my supervisor we're going to come in and

7:28do full physical

7:30and decide if there's any tests that

7:31need to be done and we'll get to the

7:33bottom of it that's great okay thanks

7:35very much all right you soon