NAATI CCL Nepali Health & Medical Practice Dialogues — Worked Examples

Good morning. I can see from your file that you've been experiencing headaches for the past two weeks. Can you describe the pain for me?

जी, डाक्टर। दुखाइ मुख्यतया मेरो टाउकोको दाहिने भागमा हुन्छ। बिहानदेखि सुरु हुन्छ र दिनभर बढ्दै जान्छ। कहिलेकाहीं रिंगटा पनि लाग्छ।

I see. Have you noticed any changes in your vision, or do you feel nauseous when the headaches are severe?

मेरो दृष्टि कहिलेकाहीं अलिक धमिलो हुन्छ, तर वाकवाकी हुँदैन। म पारासिटामोल खाइरहेको छु, तर केही घण्टा मात्र काम गर्छ।

I'd like to run some tests, including a blood test and possibly a CT scan, just to rule out anything serious. I'll also refer you to a specialist if needed.

यो सुन्दा अलिक चिन्ता लागेको छ। परीक्षणको नतिजा आउन कति समय लाग्छ? मलाई चिन्ता छ कि यो कुनै गम्भीर कुरा त होइन।

The blood test results should be available within three days. The CT scan might take about a week. Please try not to worry — most headaches have simple causes like stress or tension.

धन्यवाद, डाक्टर। यसबीचमा म पारासिटामोल खाइरहनुपर्छ, कि तपाईं अरू बलियो औषधि सिफारिस गर्नुहुन्छ?

You can continue with paracetamol for now, but don't exceed four grams per day. I'll also prescribe a mild anti-inflammatory that may help with the pain. Make sure you stay hydrated and get enough rest.

बुझें। म बाहिर जाँदा रिसेप्सनमा परीक्षणको बुकिङ गर्छु। डाक्टर, तपाईंको समयको लागि धन्यवाद।

One more thing — if your headaches suddenly become much worse, or you experience sudden vision loss or difficulty speaking, please go to the emergency department immediately.

म त्यसो गर्छु। सल्लाहको लागि धन्यवाद, डाक्टर। नतिजा आएपछि फलो-अप भेटको लागि अवश्य आउँछु।

Hello, I'm the triage nurse. Can you tell me what brought you to the emergency department today?

आज बिहानदेखि छातीमा दुखाइ छ। कसिएको र गह्रौं जस्तो लाग्छ, जस्तो कसैले छातीमा थिचिरहेको छ। सास फेर्न पनि गाह्रो भइरहेको छ।

On a scale of one to ten, how would you rate the pain? Does it spread to your arm, jaw, or back?

सात जतिको छ जस्तो लाग्छ। दुखाइ बायाँ पाखुरामा फैलिन्छ। अलिक पसिना पनि आउँछ र टाउको हल्का लाग्छ।

Given your symptoms, we need to act quickly. I'm taking you to the treatment area immediately. We'll do an ECG and blood tests right away. Are you allergic to any medications?

छैन, मलाई कुनै एलर्जी छैन। तर म दैनिक रक्तचापको औषधि खान्छु। मलाई लाग्छ यसलाई एमलोडिपिन भनिन्छ।

Thank you. Is there anyone we should contact — a family member or next of kin?

हो, कृपया मेरी श्रीमतीलाई फोन गर्नुहोस्। उनको नाम मेई हो र नम्बर 0412 345 678 हो। उनी अहिले काममा हुनुपर्छ।

We're going to monitor your heart rhythm and give you some aspirin as a precaution. A doctor will see you within the next few minutes.

धन्यवाद। के यो हार्ट अट्याक हो? म साँच्चै डराएको छु।

We won't know until we've done the tests. Try to stay calm and rest. The medical team will explain everything once they've assessed you.

ठीक छ। यति चाँडो कदम चालिदिनुभएकोमा धन्यवाद। तपाईंको सहयोगको कदर गर्छु।

Good afternoon. I see you have a prescription here. Before I fill it, I need to ask a few questions. Is this medication for you?

हो, मेरो लागि हो। मेरो डाक्टरले उच्च कोलेस्ट्रोलको लागि लेखिदिनुभयो। उहाँले भन्नुभयो कि दैनिक खानुपर्छ।

This is atorvastatin, a statin medication. Take one tablet at night, preferably at the same time each day. Are you currently taking any other medications or supplements?

म भिटामिन डी सप्लिमेन्ट खान्छु र कहिलेकाहीं फिश ऑयल क्याप्सुल पनि। म रक्तचापको गोली पनि खान्छु — मेटोप्रोलोल हो जस्तो लाग्छ।

There are no major interactions between those medications. However, avoid eating grapefruit while taking atorvastatin, as it can increase drug levels in your blood. Common side effects include muscle pain and digestive issues.

बुझें। ग्रेपफ्रुट पूर्ण रूपमा नखाने? र मांसपेशी दुख्यो भने के गर्ने? औषधि छोडिदिने?

If you experience significant muscle pain, see your doctor before stopping the medication. Don't stop it on your own.

बुझें। यसको कति खर्च लाग्छ? मसँग कन्सेसन कार्ड छ।

With your concession card, the cost is seven dollars sixty for a month's supply. Would you like me to put it on your medication record?

हो, कृपया। अर्को पटकको लागि सहज हुनेछ।

Your medication will be ready in about ten minutes. You can wait here or come back later. Do you have any other questions?

छैन, यति नै हो। सबै कुरा यति स्पष्ट रूपमा बुझाइदिनुभएकोमा धन्यवाद।

Good morning. I'm Dr Chen, the cardiologist. Your GP referred you because of some abnormal results in your recent ECG. How have you been feeling?

प्रायः ठिक छु, तर कहिलेकाहीं कुनै कारण बिना मुटु छिटोछिटो धड्कन्छ। यो सामान्यतया रातमा वा आराम गर्दा हुन्छ।

How long do these episodes last, and how often do they occur?

पाँच देखि दस मिनट जति रहन्छ र हप्तामा दुई-तीन पटक हुन्छ। लगभग दुई महिना अघिदेखि सुरु भयो।

I'd like to perform an echocardiogram today — an ultrasound of your heart. It shows how your heart is functioning. We may also fit a Holter monitor to record your rhythm over twenty-four hours.

इकोकार्डियोग्राम दुख्छ? र होल्टर मनिटरको लागि अस्पतालमा बस्नुपर्छ?

No, the echocardiogram is completely painless — it's just like a regular ultrasound. The Holter monitor is a small device you wear home and return the next day.

राहत भयो। मेरा बुबालाई मुटुको समस्या थियो, त्यसैले म धेरै चिन्तित थिएँ।

Family history is important, and it's good that you're getting this checked. We'll have a much clearer picture after these tests. In the meantime, avoid caffeine and alcohol.

म सामान्यतया दिनमा दुई-तीन कप कफी खान्छु। पूर्ण रूपमा छोड्नुपर्छ?

Try to reduce it to one cup in the morning at most. Caffeine can trigger the palpitations you've been experiencing. I'll also check your thyroid function, as that can sometimes cause similar symptoms.

धन्यवाद, डा. चेन। यी सबै परीक्षणहरूको नतिजा कहिले आउँछ?

Welcome back. How have you been since our last session? I remember you were going through a difficult time at work.

कठिन केही हप्ता भयो। मेरो म्यानेजरसँग बहस भयो, र अहिले कुनै कुरामा ध्यान केन्द्रित गर्न सकिरहेको छैन। निद्रा पनि राम्रो आउँदैन।

I'm sorry to hear that. When you say you can't concentrate, can you give me an example of how that's affecting your daily life?

म कुराहरू बिर्सिरहेको छु — भेटघाट र डेडलाइन जस्ता। हिजो म बच्चाहरूलाई विद्यालयबाट लिन जान बिर्सें किनकि मलाई समयको पत्तै भएन।

That must have been very stressful. It sounds like the anxiety from work is spilling over into other areas of your life. Have you had any thoughts of harming yourself?

होइन, त्यस्तो केही छैन। बस अत्यधिक दबाव र थकान महसुस भइरहेको छ। कहिलेकाहीं सोच्छु कि कहिल्यै कुरा राम्रो हुनेछ कि।

Those feelings are very common when we're under prolonged stress. I'd like to teach you some breathing techniques that can help manage the anxiety in the moment. Would you be open to that?

हो, अहिले म जे पनि प्रयास गर्न तयार छु। मेरी श्रीमतीले भन्नुभयो कि मलाई औषधि चाहिन्छ होला। तपाईंलाई के लाग्छ?

That's something your GP can assess. I can write a letter recommending a review if you'd like. In the meantime, let's focus on some practical strategies. How much exercise are you getting?

लगभग गरिरहेको छैन। पहिले हप्तामा तीन पटक जिम जान्थें, तर महिनौंदेखि गएको छैन।

Getting back to some form of regular exercise, even just a thirty-minute walk each day, can significantly improve sleep and reduce anxiety. Let's set that as a goal for this week.

ठीक छ, म हरेक बिहान काम अघि हिँड्ने कोसिस गर्छु। धन्यवाद — यसबारेमा कुरा गर्दैमा अलिक राम्रो महसुस भइरहेको छ।

Good morning. I can see from your notes that you're here for a toothache. Can you point to where the pain is?

यो दाँत हो, तलको दाहिने तर्फ। लगभग एक हप्तादेखि दुखिरहेको छ, विशेषगरी चिसो खाँदा वा पिउँदा।

Let me take a look. I'm going to use this mirror and probe to examine the area. You might feel some pressure. When did you last visit a dentist?

तीन वर्ष जति अघि होला। म थाहा छ बढी नियमित रूपमा आउनुपर्थ्यो, तर काममा व्यस्त भइरहेको थिएँ।

There's a large cavity in your lower right molar. The decay has gone deep, causing the sensitivity. We'll need an X-ray to see if the nerve is affected.

त्यसो भए मलाई रुट क्यानाल चाहिन सक्छ? मेरो साथीले गरेको थियो र धेरै दुखेको भनेको थियो।

Let's wait for the X-ray results before deciding treatment. Root canals today are much more comfortable than before. We use local anaesthetic, so you shouldn't feel pain.

उपचारको खर्च कति हुन्छ? मसँग प्राइभेट हेल्थ इन्स्योरेन्स छैन।

A filling would be around two hundred dollars, and a root canal with a crown can range from one thousand to two thousand dollars. We do offer payment plans if that helps.

मैले सोचेभन्दा महँगो छ। कुनै सस्तो विकल्प छ?

If the X-ray shows the nerve isn't damaged, a filling should be sufficient and much more affordable. Let's take the X-ray first and then discuss your options.

ठीक छ, एक्स-रे गरौं। मलाई बस दुखाइ रोकिन चाहिएको छ।

Hi there. I'm your physiotherapist. I understand you've been referred for lower back pain following a workplace injury. Can you tell me what happened?

लगभग तीन हप्ता अघि कामको ठाउँमा गह्रौं बाकस उठाउँदा कम्मरमा तीव्र दुखाइ भयो। त्यसदेखि अहिलेसम्म ठीक भएको छैन।

On a scale of one to ten, how would you rate the pain right now? And does it travel down either of your legs?

अहिले पाँच जति छ, तर निहुरिँदा वा धेरै बेर बसँदा आठ जतिसम्म पुग्छ। कहिलेकाहीं बायाँ खुट्टामा झनझनाहट हुन्छ।

The tingling could indicate nerve involvement. I'm going to do some physical assessments now — I'll ask you to do some movements and I'll check your reflexes. Please tell me if anything causes sharp pain.

ठीक छ। म भन्न चाहन्छु कि मेरो वर्कर्स कम्पेन्सेशन क्लेम स्वीकृत भइसकेको छ, त्यसैले उपचार खर्च कभर हुन्छ।

That's good to know. Based on my initial assessment, I'd recommend twice-weekly sessions for the next six weeks. We'll focus on strengthening your core muscles and improving flexibility.

के मैले घरमा पनि व्यायाम गर्नुपर्छ?

Absolutely. Home exercises are essential for recovery. I'll give you a printed sheet with five simple exercises to do daily. They should only take about fifteen minutes.

मेरो रोजगारदाताले सकेसम्म चाँडो फर्कन चाहन्छन्। तपाईंको विचारमा म कहिले फर्कन सक्छु?

It depends on your role. Light duties might be possible in two to three weeks. I'll prepare a return-to-work plan and communicate with your employer's injury management team.

धन्यवाद। यो सम्पूर्ण अवस्थाले धेरै तनाव दिएको थियो, त्यसैले योजना भएकोमा राम्रो लाग्छ।