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  "text": "This patient is [PERSON_NAME] [PERSON_NAME]. [PERSON_NAME]. Date of birth is [DATE_OF_BIRTH], [DATE_OF_BIRTH]. Nothing there, but. Okay, well, take me through what's been going on. Every year I seem to get my left sinus gets messed up. But this year is the worst. It's just always, like, really sore, jammed up. Feels like I constantly have to pick at it. I really try not to. I've been doing [DRUG] pots and different [DRUG] [DRUG]. I was on a couple rounds of [DRUG] [DRUG] and [DRUG]. I feel like I got two bumps on top of my head. Yeah. And then sometimes, like, my forehead, like, gets swelled up. Okay. Oh, yeah. It really. Yeah, it just hurts. And is it sore just right at the nostril or is it sore, like, deeper inside or where do you feel? Yeah, right inside. But it feels kind of back, too. Okay. And towards, like, the center of my nose. Like, I've taken, like, my iPhone light, you know, and tried to look. It seems like it's of. Kind. Kind of towards the middle of my nose. It's all kind of raw. Okay. Now, how long has this been going? So how long has this most recent set of, like, symptoms been going on for now? I'm going on for [DURATION] [DURATION] [DURATION]. Okay. And before this, how had you been feeling before this? Before this flare up? Yeah, fine. Okay. Like, usually a [DRUG] [DRUG] takes care of it. Like, I get it. I seem to get it every winter, but this year, nothing seems to work. Are you getting any headaches at all? Yeah. Where do you feel those typically? Dizziness. Okay. I don't know. Just my head in general. I just feel like I want to take a pin and just pop and put a Q tip in my ear. And I hear, like, crunching. If I turn my head, I hear crunch. Crunching. There's ringing in my ears sometimes. Are you getting, like, a pressure in your ear or popping type sensation? I don't know about. There has been a time or two that I felt like my ears need to pop. Okay. How about difficulty breathing through the nose? Okay. Yeah. Okay. This morning when I blew my nose or, like, breathe in, it felt like I couldn't even, like it was, like, jammed up. Okay. And how about your sense of smell and sense of taste? How do those seem to be doing? I think it's fine. Okay. Drainage down the back [MEDICAL_PROCESS] [MEDICAL_PROCESS] throat at all? Yep. Blowing lots of mucus out the front [MEDICAL_PROCESS] [MEDICAL_PROCESS] nose at all? Yeah. Okay. And then do you have [MEDICAL_CONDITION] [MEDICAL_CONDITION] at all that you suspect? I have hay fever. Okay. And so you've been on the [DRUG] [DRUG]. [DRUG]. The other [DRUG]. The [DRUG] [DRUG] is at the [DRUG] or. Yeah, [DRUG]. I have like a generic one or whatever as well. Doing [MEDICAL_PROCESS] every day. I have a [DRUG] [DRUG] [DRUG]. I take some [DRUG] [DRUG] at night. I'll try [DRUG]. I feel like you made a fire going 24.7mm. So what would you say is the worst, like, one or two symptoms for you? I don't know. I mean, it just really is annoying. And hurts. Yeah. And headache and sometimes dizziness, I guess. Okay. Just feels there's a lot of pressure in my head. And like, my girlfriend is like, once in a while giving me like a head massage where I put like, ice on it. And then I wake up in the morning, it does seem like it's moved or something. I don't know. Okay. Weird. Yeah. Well, let's check it out. All right, pause on this. Okay. Next paragraph is [MEDICAL_PROCESS] [MEDICAL_PROCESS]. [MEDICAL_PROCESS] [MEDICAL_PROCESS] is significant for. Okay, wait, wait. It's loading. [MEDICAL_PROCESS] [MEDICAL_PROCESS] is significant for anterior nasal dryness [MEDICAL_PROCESS] [MEDICAL_PROCESS] lateral nasal wall and septum with mild mucous crusting and mild crusted blood, period. The right anterior nasal cavity demonstrates a large inferior turbinate, but normal muco mucosa, period. And then the remainder [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] is normal. Our next section is [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Date [DATE] [DATE], [DATE]. Open print outside facility. Closed parent. Next line. I reviewed the actual images from the patients. [MEDICAL_PROCESS] [MEDICAL_PROCESS], period. The images demonstrate normal sinus passages common without any mucosal thickening or discharge. Present, period. The nasal septum deviates to the right and there is a small nasal septal spur present contacting the inferior turbinate on the right, period. There is no generalized intranasal mucosal crowding, period. No [INJURY] [INJURY]. Polyps are present, period. Next paragraph is assessment. Chronic. Number one is [MEDICAL_CONDITION] [MEDICAL_CONDITION]. Number two is [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION]. Next paragraph. The patient reports a history of annual sinus problems on the left side which typically don't last as long as it as they do this as they did this year, period. He has been on two rounds of [DRUG] and also uses [DRUG] and an [DRUG] qday, but still has symptoms, period. Most problematic is left sided intranasal pain which is felt further back in the nose and upward, period. On [MEDICAL_PROCESS] [MEDICAL_PROCESS], the left anterior nasal cavity on both sides demonstrates significant dryness, irritation, comma. But the remainder [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] is normal, period. Next paragraph, [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] from an outside facility on [DATE] [DATE], [DATE] are completely normal. Period. Next paragraph. Plan it is entirely possible that the patient has a [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] period. As such comma, I would recommend a [DURATION] [DURATION] course of new [DRUG] [DRUG] in the left nasal passage bid period. I would then want him to follow this with [MEDICAL_PROCESS] [MEDICAL_PROCESS] applications of [DRUG] in the nasal passage comma, liberally applied period. Number Next I would then have the patient call us if there is no improvement in [DURATION] [DURATION] time period, we could start him on a [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] for a [DURATION] [DURATION] trial [DURATION] [DURATION] period. Yeah, she said they're down though. We could also recommend [DRUG] [DRUG] [DRUG] period. Number next is return to clinic based on above.",
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