[doctor] hey , ms. james . nice to meet you . [patient] nice to meet you , dr. cooper . how are you ? [doctor] i'm well . hey , dragon , i'm seeing ms. james . she's a 42-year-old female , and what brings you in today ? [patient] i hurt my , uh , finger when i was skiing this past weekend . [doctor] really ? [patient] yeah . yeah , so , um , i was going down hill , double diamonds , uh , double black diamonds , and i just lost control , and i , you know , flipped down a few ways , but , uh , somewhere along the way , i , i jammed my , my index finger on something . i'm not sure what . [doctor] okay . so this happened last saturday , you said ? [patient] it was saturday , yes . [doctor] okay . so about five days of this right index finger pain . [patient] mm-hmm . [doctor] have you taken any medicine for it ? [patient] i took some ibuprofen . um , did n't really seem to help . [doctor] okay . have you iced it or put a splint on it ? [patient] no . [doctor] okay . and what would you rate your pain ? [patient] it's about a seven . [doctor] a seven out of 10 pain . um , and no other injuries while you went down this double black diamond ? [patient] no , interestingly enough , this is the only one . [doctor] okay . well , i guess you escaped ... i mean ... [patient] could have been much worse . [doctor] could have been much worse , yes . so , um , do you have any medical problems ? [patient] um ... yeah , i'm ... i have chronic constipation . [doctor] do you take any medicine for it ? [patient] miralax . [doctor] and does that help ? [patient] seems to flow nicely . [doctor] good for you . [doctor] um ... have you ever had any surgeries before ? [patient] yes , i had my appendix out when i was seven . [doctor] okay . um , let's look at your x-ray together . hey , dragon , show me the last x-ray . all right . so looking at your right hand here , and that index finger looks great . so all the joints , bones are in the right places , no fractures , so you've got a normal right hand x-ray . um , let's go ahead and check your finger out . now does it hurt when i push on your finger like this ? [patient] yes . [doctor] does it hurt when i pull your finger like this ? [patient] yes . [doctor] does it hurt when i squeeze over this joint here ? [patient] yes . please do n't do that . [doctor] does it hurt when i squeeze over this ? [patient] yes . [doctor] okay . um ... so with your x-ray , and with your exam , looks like you have a sprain of your distar- distal interphalangeal joint . it's called your dip joint , of your right index finger , and so what we're gon na do for that is we're gon na put a splint on that right finger . i'm gon na give you a strong antiinflammatory called mobic . you'll take 15 milligrams once a day . i'll prescribe 14 of those for you . and i want you to come back and see me in two weeks , and let's make sure it's all healed up and if we need to start any hand therapy at that point , then we can . do you have any questions for me ? [patient] no questions . thank you . [doctor] you're welcome . hey , dragon , order the medications and procedures mentioned . and why do n't you come with me , and we'll get you checked out ? [patient] okay . [doctor] hey , dragon , finalize the report .
PLAN

At this point, I discussed the diagnosis and treatment options with the patient. I have recommended a splint. A prescription is provided for Mobic 15 mg once a day, dispense 14. She will follow up with me in 2 weeks for a repeat evaluation. If she is unimproved, we will consider hand therapy at that time. All questions were answered.
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