{ "text": "This patient is [PERSON_NAME] [PERSON_NAME]. [PERSON_NAME] [PERSON_NAME]. Date of birth is [DATE_OF_BIRTH] [DATE_OF_BIRTH], [DATE_OF_BIRTH]. Well, tell me what's been going on. So early this year had just a random onset of left [MEDICAL_PROCESS] crackling. It just started with breathing in and out and didn't really stop. It was just constant in and out. Didn't matter what I did to it. I could try and blow pressure and make it worse or it would make any change. This constantly was there. Randomly. It would go away. I didn't do anything to it. Just randomly would go away and then it would come back. And I was like, I'll give it [DURATION] [DURATION] [DURATION]. Didn't go away. I'll give it [DURATION] [DURATION]. Didn't go away. I'll give it like [DURATION] [DURATION] [DURATION] [DURATION] [DURATION]. Nothing. So I'm like, that's why I called. I'm like, well, there's an issue going on. I think it lasted probably maybe [DURATION], [DURATION] [DURATION] and then it just went away. I still kept appointment because I still think it's important. Yeah. But every now and then I'll get a little bit of like a crescendo of pain and then I'll go away. Ah, okay. But very mild, and it's kind of rare, but it was still there. Currently, maybe a little bit of fullness in the [MEDICAL_PROCESS], but nothing that is jumping out to me. So pretty stable, and that's basically it. Okay. Does the hearing feel impacted by this at all? Good question. I don't think so, but then again, I don't know. Like, I feel like I can hear fine. Okay. But maybe I'm habituated to whatever's going on. I feel like I hear just fine. Okay. Now, do you have any history of problems? I mean, nobody's been on an airplane or not many people have been on airplanes for a while, but any history problems on airplanes with your ears equalizing? Not beyond, like, normal. No, not really. I mean, sometimes when I'm in the car, I'm going like, we went to a trip to [LOCATION] [LOCATION] [DURATION] [DURATION] lot of hilly mountains. There's some times where, like, the ears wanted to pop. It was getting kind of painful and then go away. Like, okay. So here and there, but nothing that jumps out to me. And then before this, did you have any type of an [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION], a [MEDICAL_CONDITION] [MEDICAL_CONDITION], anything you could think of? I did not have much of that. The only things I've really gotten is just the side effects from the vaccines. And I've had two vaccines in the booster. Okay. So usually the. The last one, I think I Got a little bit of [MEDICAL_CONDITION]. [MEDICAL_CONDITION] [MEDICAL_CONDITION]. Because I usually. If I'm gonna get sick, it's [MEDICAL_CONDITION]. Okay. More than respiratory. I always get some sort of [MEDICAL_CONDITION] [MEDICAL_CONDITION] each year. All right. Yeah. Okay. Like, one that hurts, like, behind the eyes, like, really bad. Yeah. For, like, a good [DURATION] [DURATION] [DURATION] [DURATION], but I haven't had one, thankfully. Good. Okay. And then any other symptoms that you wanted to mention at all? The only thing that's maybe also concurrent is a little bit of left [MEDICAL_PROCESS] issue in the past. Okay. I have a. I work as a [OCCUPATION] [OCCUPATION] treating [MEDICAL_CONDITION]. Oh, you do? So I just have, like, a. A [INJURY] [INJURY] [INJURY] [INJURY] [INJURY]. [INJURY]. Okay. Replaces every once in a while. So it's not. It's not terrible. But do you work. Who do you work with? Do you work with [PERSON_NAME]. [PERSON_NAME]? Wow. He referred me to you. Okay. Tell me. Say hello. Yeah. Great. Awesome. Yeah. No, you like. I mean, I. Being in [MEDICAL_PROCESS], nose, and throat, and we used to. So when I. Let me try it again, when I trained, I did a lot of [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS], so we had a lot of debilitated patients. So [MEDICAL_PROCESS] [MEDICAL_PROCESS] was, of course, always crucial in terms of getting our patients mobilized and strengthened, strong and helpful. And so I've never. I've always had good experiences with [OCCUPATION] [OCCUPATION] and then especially [OCCUPATION] [OCCUPATION]. That's, like, immeasurably important. I mean, people. And from my standpoint, I see a lot of people with this pressure in the [MEDICAL_PROCESS] that doesn't resolve with [MEDICAL_PROCESS] tubes and with [MEDICAL_CONDITION] [MEDICAL_PROCESS] and all these things, and they end up getting pressure, basically. Because my theory is that the muscles pulling on the mandible are pulling on the jaw joint, which is, of course, connected to the [MEDICAL_PROCESS] canal, and that can cause this oral fullness. And so I've had people go to [MEDICAL_PROCESS] [MEDICAL_PROCESS] for [MEDICAL_CONDITION], and, like, they're like, oh, my God, you saved me. Because this kind of stuff that you were having would drive them crazy. Yep. Yeah. So thank you. For sure. Yeah. Well, have a seat. Let me get a good look. So is that when you trained me? Ask you this because I'm having trouble speaking. How did you decide that that was the aspect of [MEDICAL_PROCESS] [MEDICAL_PROCESS] that you wanted to. I just was looking for a job, and that's one of the jobs that came up. Okay. And they mentioned that [MEDICAL_PROCESS] was a specialty, and I had a [MEDICAL_PROCESS] issue. So it's just like, well, kind of interesting. Check it out. It stuck. But in school, I never really had an interest. I kept an open mind in school. Yeah. Because so many people told me, you know, what you wanted to do when you went to school is completely different when you wanted to come out. So I just always kept an open mind. Okay. Did you train in [LOCATION] or did you. Yep. Where did you go for [MEDICAL_PROCESS] [MEDICAL_PROCESS]? Yeah, [ORGANIZATION] [ORGANIZATION]. Oh, okay. Yeah, my have a nephew who's the second year at [ORGANIZATION] and he's loving it. Big, big classes. Yeah, they've all increased their class sizes, which is a little scary. How big are they now? I mean, we were [ORGANIZATION] only 24 to 25, but some of them increased like twofold, like from 50 to 100 or 50 to 75. [ORGANIZATION] [ORGANIZATION] [LOCATION] expanded its medical school to [LOCATION] [LOCATION], particularly for primary care. And yeah, they train several hundred [OCCUPATION] [OCCUPATION] a year, Probably I think 3, 4, 480 between here and up there. That's a lot. Yeah. Okay, now if I can have you tilt your head away from me. Just kind of tip away. Perfect. Good, good. So your eardrum's looking excellent. There's no retraction or lateralization, so it's not puffing out or sucking in, which is good. There's no fluid. Your anatomy actually is amazing. This would be like. Residents would like die to see this. Yeah, got really good. Really good. Normal middle [MEDICAL_PROCESS] anatomy. I could see through the eardrum practically. Nice. Yeah. Good. Okay, [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] Next. Yeah, I can even cover your thing. See? Do we have a. No, we don't. A light. Let me get a light. That'll be really helpful. Yeah, definitely. Just be right there. Of course. All right, [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Nice. Good. Okay. I do have [MEDICAL_CONDITION] [MEDICAL_CONDITION] a lot of things. Had [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] and I had a cat with me and always I'd had. I had [MEDICAL_CONDITION] [MEDICAL_CONDITION] for [DURATION]. That's what made I always sleeping with my mouth open. And it created a problem. So I was like that. But, you know, got that treat. I figured out how to treat it. You sign like nose spray stuff. I used a thing to hold my jaw close so I can learn how to breathe through my nose again. Okay, Kick the cat out, clean my room. I'll find out. No idea if it's made any issues with my sinuses. Okay. And [MEDICAL_CONDITION] can definitely play a role in what you're having. Although probably not right now. You open it up nice and warm, wide. Go ahead and say ah. Cuz when people get symptoms like this, a lot of times they get them during the [MEDICAL_CONDITION] seasons. Check your neck and lymph nodes. Good, good. All right. No, enlarge them. Does have a seat again. Of course. Wash hands one more time. Okay, so this is very likely from your [MEDICAL_CONDITION] [MEDICAL_CONDITION]. Your [MEDICAL_CONDITION] [MEDICAL_CONDITION] probably [MEDICAL_CONDITION] [MEDICAL_CONDITION], and sometimes people have [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] or it just takes even a little bit of, like, even a mild [MEDICAL_CONDITION] or an allergen or irritant to cause [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION]. But so when you're looking at the [MEDICAL_PROCESS], we have, obviously, the [MEDICAL_PROCESS] canal, the eardrum. And so the eardrum separates the outer [MEDICAL_PROCESS] from the middle [MEDICAL_PROCESS] space. The pressure behind the eardrum is supposed to be the same as the pressure outside, and that's achieved by the [MEDICAL_CONDITION] [MEDICAL_CONDITION]. So that's the tube that runs from the bottom of the middle [MEDICAL_PROCESS] to the back of the nose. So this is never open like that. It's more [INJURY] [INJURY] flat tube. Oh, got it. Yeah. Okay. And so if there's any swelling within that tube, it just kind of plugs. Oh, I see. Right. And so when that happens, then. Well, a lot of times the first step is you start to hear a lot of crackling and popping, which is actually the mucosa sticking and crackling and popping. Oh, that's what it is. Yeah. And it's also air going in and out inefficiently and air getting plugged in there and then crackling and popping out. And then it comes out, then it crackles and pops in, and it's just kind of like circus of noise until. Yeah. Until either things plug up completely or they start to get better. And so yours is obviously getting better. Yes. Meaning your [MEDICAL_CONDITION] [MEDICAL_CONDITION] is decongesting on its own and slowly. Slowly equilibrating the pressure. And what I see today on the exam is that your eardrum has this nice bowl shape, which is exactly what we like to see. It's not bulging or retracting. So if there's an increase in pressure, it'd probably be bulging out. Yeah, exactly. So normally we tell people about [DURATION] [DURATION] for symptoms to really resolve when. After onset. So you're in the. In the ballpark. Okay. You know, probably another [DURATION] [DURATION], I imagine, for, like, the pressure feeling. Yeah. Okay, let's. That's good at least. Yeah, I'm happy about that. So. Okay. Any questions at all? No, if it happens again, just. I use a [DRUG], no spray. Excuse me. Oh, that was a Giant sneak. Oh, my Lord. Sorry. Burst [DURATION] [DURATION] blood vessels. So you use a [DRUG] [DRUG] and. Yeah, and then I also use a [DRUG] [DRUG] [DRUG]. Okay. With like, aloe vera in it, some natural stuff just to keep things moisturized. Yeah, that's good. Yeah, that's basically all I use. Yeah. Use that. Use the [DRUG] [DRUG]. If the onset of symptoms or at the onset of symptoms, you can use it, like, I would say, [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS], [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. And the longer you use it, the better. So a lot of times I would have you continue for like, [DURATION], [DURATION] [DURATION] just to really help decon press that you station tube and get it to open. Absolutely. I think I used it for like, a good solid [DURATION] [DURATION] [DURATION] when it was happening. Oh, good. So you did the right thing. Good, good. I'm glad I'm doing the right thing. Yeah. Cool. Yeah. Other than that, I didn't. I just. I don't take [DRUG] when I need it, but yeah. Yeah, makes sense. Cool. Awesome. Yeah, that's. Questions otherwise at all? Not in particular. Just want to make sure that nothing more serious was happening. Right. Yeah. That's real reasonable. Yeah, yeah, I'm on board completely. I like my hearing. Yeah. I don't want to ever screw it up, so. Right. And. And with this. Yeah, you would. Most people, when you have normal hearing, if you do have a decrease in hearing, you should notice it. So I have a feeling that you're hearing, if we got a test, would be doing pretty well at this point. So. Yeah. So is that if this happens again and. And it progresses, is that basically one of the telltale signs is like, oh, hearing is decreased. Yeah. It can acutely decrease hearing, but it's re. So once the pressure equalizes again and the eustachia tube starts working, then the hearing just comes right back up again. Okay. So, yeah. What is your treatment for something like that? If it doesn't reverse. If it doesn't reverse. And a lot of times we'll do like a [DRUG] [DRUG] and have the person use this, the [DRUG] [DRUG], for like [DURATION] [DURATION]. Okay. Yeah, it's pretty slow. And then if that doesn't work and like, [DURATION], [DURATION] [DURATION] later, people are still plugged then in. Ear tube is a plug as an option for some people. Yeah. Yeah. So got it. Cool. Don't need that, thankfully. Cool. All right. Yeah. But, yeah, I think that should be it. Cool. Yeah. But if you have questions or whatever, just my chart us or call and. Okay. There's any issues at all. But I think you're. You're in. You're definitely went in the right direction, and you definitely did the right things. Cool. So it's good to hear. Yeah. Cool. Sweet. All right. Which is nice. Yeah, yeah, yeah. All right. You go back to work now. I do not. I have [DURATION] [DURATION] [DURATION] today. Excellent. Let's go see an apartment. Because I'm in the middle with my girlfriend. We're just having a ball [INJURY] [INJURY] time looking for a place. Sarcastically. Is it really difficult to find places? Like, we're just picky. Okay. Yeah, there's plenty of places. We're just very picky. It's good to be picky. Yeah. But it also makes it a headache. Yeah, but you don't want to live in a dump. I mean, not even a dump. You want to live in a place that you enjoy going to, like, coming home to and. Exactly. Yeah. Yeah. Totally Cool. And then that away all the way to the end and then. Right. All right. Yep. Take care. It was nice to meet you. Yeah. So I would just have you spray his right side and is he here already? Yeah. Oh, boy. He's in a rush. He's grabby. Hopefully he's not too grabby. Hopefully he's not bleeding. Yeah, that's why he's crabby. He bleeds a lot. Oh, boy. Sorry, I forgot to hit pause there. You got to hear the whole thing. 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