1 Viral Sore Throat 2 Friday, Oct 4 1996, late afternoon 3 4 5 6 7 ((The mom has taken her daughter to the doctor because of a sore throat and fever. She's missed one day of school yesterday; today her fever is down but throat is still sore. The doctor has just completed the history taking and physical exam, and now begins presenting the diagnostic conclusions and treatment recommendations.)) .hh Okay. .hh She looks: like one: hh of: thuh viral: sore throats: th't's been goin' around. =Okay:, 8 9 DOC: 10 11 MOM: Mm hm:,= 12 DOC: 13 DOC: 14 15 MOM: DOC: 19 DOC: 20 MOM: DOC: 24 29 PAT: DOC: PAT: DOC: 30 DOC: MOM: 33 1522222222222285-821386287F7F7777785 42 .hh Uhm: h We have not had (1.1) uh lot of strep throa:t er: things that need antibiotics at thuh moment. Thuh kids ('ve kinduv all went back tuh schoo: 1,) Mm hm:,= =And they're all sharing all these::=silly little: viruses. [.hhh [Mm hm:, Uh:m, (0.2) tlk=What (.) I would (0.4) recommend is is that if thuh fever (0.5) .hh Was your throat worse: yesterday or today::- or: - w- what. hh Uhm:, (0.4) tlk=I think it was: hh (0.5) worser today. It was worser today?, But it's startin' tuh go down now. It's startin' tuh feel better? (.) Okay.= =She had no symptoms yesterday during thuh day except thuh- thuh temperature? .hh An' then last night: she started sayin' it: was kind(uv) hurting when she swallowed an' then this morning, .hh Okay:, 34 DOC: MOM: DOC: So it wasn't like uh real major (h-) ( ( ) [Right. (1.0) 39 DOC: 40 DOC: 41 43 44 DOC: 45 46 47 48 49 50 PAT: DOC: 52 MOM: 53 DOC: 54 55 MOM: So it's like- kinda (0.5) (yeow:.??) .hhh Uh:m: (1.0) -hhh I wish (ed) it weren't Friday it'd be uh little bit easier I'd watch='er for uh day er two without worrying about 'er. (1.0) .hh Uhm, (0.2) How bad do you feel. (1.0) I'm startin' tuh feel better except fer .h#h- (.) #huh huhm#. (0.2) like .hh when I sometimes I breathe (some-) (ya know) my throat will get clogged up 'n stuff, Okay. .hh Now see sh- she's gonna congest u:p. (.) Uh huh, She's gonna get uh good cough outta thi:s, She's going to get all mucusy, I mean- Mm hm, 56 DOC: 57 MOM: 58 DOC: 59 DOC: 60 61 62 MOM: 63 DOC: 64 DOC: 65 66 67 MOM: 68 DOC: Okay, 69 MOM: 70 DOC: [.hh 71 DOC: 72 73 MOM: 74 DOC: 75 76 MOM: 77 DOC: 78 DOC: 79 80 MOM: This is just what I've been seeing. [(Okay.) [(O:kay,) .hh Uhm: if she's not running uh fever an' only ran thuh fever for uh day I'd really ra:ther: not put 'er on antibiotics if I can help it. Yeah. Okay, .hh There's s::o much out there now: about: (.) #w: #what happens with these kids with thuh:- resistance tuh thuh a[ntibiotics. [Right. [(Ri:ght. Uh:m: I would give her Tylenol if thuh fever comes back, Mm h[m, [Mkay, If thuh fever persists through thuh weekend .hh I've gotta take another look. Mm hm, = = Okay, .hh Uhm, (.) I would use something like uh dimetap dee em, if she starts tuh get congested an' cough, Mm hm, ) 81 DOC: Okay, 82 DOC: 83 84 85 MOM: 86 DOC: .hh Uh: I'd give 'er lots of fluids::, -I'd pick up some Sucrets: :=er: ya know Chloraseptic er- [some'in: some'in' hard tuh suck on fer thuh .hh= [Okay. =fer thuh relief uh thuh throat, 87 MOM: Mm hm:, 88 DOC: Okay:, 89 DOC: .hh And uhm: let's- let's keep an eye on 'er. 91 90 MOM: DOC: 92 MOM: 93 DOC: 94 DOC: 95 96 97 98 MOM: Mm hm, 99 DOC: 100 101 102 103 104 MOM: 105 DOC: 106 MOM: 107 DOC: 108 PAT: 109 DOC: .hh [(Eh-)/ (An-) do you have uh preference as to: children's= [(Okay:, =tylenol or thuh children's advil now that they h[ave? [.hh Ya know: what- what- it's interesting you ask that because (0.2) what we have found now. is is that .hh. fever is actually- thuh best way tuh clear (0.2) something from your body, .hh An' a:11 of the: se th- they r-actually ran studies. And, .hh they: uh: (m) found that .hh if you suppress thuh fever (0.5) you end up having thuh virus in your body (0.2) longer. (.) Mmmm mm mm (.)/(,) Okay, [Mm hm, Now. Does that mean you don't give 'em any [tylenol=er= [#23HUH .h huh%23 any: A-dvil er whatever?, 110 DOC: .hh N:(,) 111 (.) 112 DOC: 113 It means that (0.2) if thuh temperature: is low grade. (.)