{ "text": "This patient is [PERSON_NAME] [PERSON_NAME]. Date of birth is [DATE_OF_BIRTH] [DATE_OF_BIRTH], [DATE_OF_BIRTH]. So take me through what has brought you in then. Well, for about a little less than [DURATION] [DURATION], I've had [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION]. And I normally try to go in every [DURATION] [DURATION] or [DURATION] [DURATION] to get a checkup with it. And just when covert started, you know, wasn't able to do that. And my insurance had since changed, so now I'm in the freighter system, not the [ORGANIZATION] system. Okay. So I figured I'd get set up over here. Perfect. So how. And I see you're on the BiPAP. Is that. Do you remember your settings? Is it. Does [TIME] and [TIME] sound familiar at all? Because that was the last one I saw. It's like [TIME] or [TIME] or [TIME] and [TIME]. Okay. And how that has that been going for you in general? Pretty good. I have a little bit of trouble. I tend to stay up late. I just sort of forget what time it is. So I've been getting about [DURATION] [DURATION] [DURATION] [DURATION] of sleep a night. It's been pretty good. The biggest issue I have is just that the. I sometimes have a hard time getting the mask to fit right. Okay. I just keep feeling like air is escaping, hitting my eyes. Otherwise, you know, I've been feeling very tired. But I don't know how much of that is related to the machine itself or just, you know, outside stressors. So I've never been very much a morning person. And so usually by like [TIME] or [TIME], I'm fully awake, but before then I tend to be a little. So would you say sleep isn't refreshing? Doesn't feel like. Well, let me ask you, do you feel refreshed when you wake up in the morning? When I wake up? Not necessarily, but usually once I get going, I feel. I feel fine. Okay. Like you said until like [TIME] or so. But like I never have that like wake up arm stretch and be like, ah, that was great, let's do it. Yeah. Right. Okay. Yeah. How about. Do you ever nod off during the day? You know, find yourself kind of doing this type of thing? Yeah, again, mostly in the morning and like very late at night. Okay. And in terms of the machine you have now, how old is it? Do you know? Is it. It's like the [ORGANIZATION] S8 or something. It's pretty old. Yeah. So this one you've been using for a while? Yeah, since. Since I got it like almost [DURATION] [DURATION] ago. Oh, okay. So my thought here would be, I think it would be a good idea to do a [MEDICAL_PROCESS] [MEDICAL_PROCESS], if you're familiar with those, they're basically, you go back to the lab and they have you go to sleep with your, with your machine on, and they adjust the settings to make sure that you're getting what you need. Because my suspicion is that you're not. Because if you're with. With the BiPAP, if it's working well, you should be more alert, you should sleep. Should at least feel like maybe helpful. And if we can get you to that point even where you're like, yeah, okay, I'm awake, I guess, rather than like, you know, kind of slugging through the morning until you wake up. Right. I think it would be a reasonable thing to do. And we can definitely assume your [MEDICAL_PROCESS] care here, of course, because you have the insurance change and we're going to take care of that for sure. But does that sound like a reasonable thing? Good. Okay. Because I think that would make a lot of, a lot of difference. And it's entirely possible that your settings have changed over the years. And it's also be good to know if you're having. Still having lots of [MEDICAL_CONDITION] [MEDICAL_CONDITION], if you're having any obstructive ones, kind of what's going on. Right. So. Because the obstructive ones we can fix. Exactly. They're trying to lose weight, but actually gone down in size, but kind of the same or up in weight. So. Okay. The size is probably a good sign. Yeah, I know. Cause I've been doing like muscle stuff. Oh, good. So that's a great sign, actually. Yeah, perfect. Okay. I know someone said anything worth doing is worth doing poorly. Which is to mean that, like, even if I can't dedicate like [DURATION] [DURATION] [DURATION] three or four times a week to be able to do exercise, if I can put in like [DURATION] [DURATION] every day, it's better than nothing. Exactly. So. No, I agree with that. That's funny though. Okay, well, have a seat. Check things out here. Let me pause. This next section is [MEDICAL_PROCESS] [MEDICAL_PROCESS] on [MEDICAL_PROCESS] [MEDICAL_PROCESS], the airway is Mallampati Class 2, period. The oropharyngeal inlet is narrow and the soft palate somewhat posteriorly positioned, period. The tonsils are one plus in size, period. On [MEDICAL_PROCESS] [MEDICAL_PROCESS], there is a blunt cervical mental angle and generally thick neck, period. The remainder of the [MEDICAL_PROCESS] [MEDICAL_PROCESS] is within normal limits. Next paragraph. Assessment number one is [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] on BiPAP. Next paragraph. The patient reports being diagnosed with [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] approximately [DURATION] [DURATION] ago, period. He has been on the same BiPAP machine since then which is BiPAP in S mode with a pressure setting of 139 or 1410 period. The patient tolerates the [MEDICAL_PROCESS] well comma, but has been having worsening issues with unrefreshing sleep and daytime somnolence including nodding off during low attention tasks period. I think the patient is due for another [MEDICAL_PROCESS] [MEDICAL_PROCESS] period. Next paragraph. Plan number one is in [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Number two is return to clinic after [MEDICAL_PROCESS] [MEDICAL_PROCESS] to review results and discuss management period. The patient is also due for a new machine at this time period. 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