Phone Visit
Narrative: SPRUCE MESSAGE VISIT Date: 2026-04-28 Encounter: Spruce text message followed by in-person office visit (Edina office, April 30) CC: Persistent cough with new headache, low-grade fever, and abdominal pain; parent requesting strep test. HPI: Nelly stayed home on April 28 with a headache and low-grade warmth (temp 99.8°F after two doses of Tylenol that day). She had a persistent cough from her prior illness. Parent noted these symptoms were similar to prior strep-positive episodes despite no sore throat. On April 29 she was sent home from school with a temp of 101.2°F. She was seen in-office on April 30. Following the office visit, parent reported she was picked up again from school with abdominal pain that worsened with movement; she had a small bowel movement at school, denied nausea, and was eating Doritos. She was acting similarly to how she appeared in the office. Assessment: Initial assessment on April 28: low-grade fever without significant throat redness on photo review, not clearly strep at that time. Progressed to higher fever (101.2°F) by April 29, prompting in-person evaluation. Post-visit, new abdominal pain reported — movement-related, mild, without vomiting; Dr. Hobbs advised monitoring. Plan: Throat photos reviewed on April 28; throat not significantly red, watchful waiting advised. In-person office visit scheduled and completed on April 30 (strep test performed per parent request). Post-visit abdominal pain noted; Dr. Hobbs advised keeping an eye on it. No prescription documented in conversation. Medications: - Tylenol Not specified; given twice on April 28 (continue) Key clinical quotes: "nice job. not looking too red. how's your overall read on her?" "Well that's not what we wanted. How long has she been home? How's she doing?" "Ok. Good to keep an eye on" Source: Spruce conversation t_27C02FVS44O00