{ "text": "The next patient is [PERSON_NAME] [PERSON_NAME]. [PERSON_NAME]. Medical record number is [HEALTHCARE_NUMBER]. Well, tell me kind of what's or not kind of tell me what's been going on. Okay, I'm here for a second opinion. [PERSON_NAME]. [PERSON_NAME] is my [OCCUPATION]. And it started [DATE] [DATE]. We're sitting down at night watching TV and all of a sudden it was just like someone turned a faucet on and just was having tons of [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. So I gargled with salt water and it happened [DURATION] [DURATION] [DURATION]. And next [DURATION] I started having a little bit of a scratchy throat on the right side. I could feel the [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] in there. And I started to take a [DRUG]. I don't tolerate [DRUG] very well, so I can only take like [MEDICAL_PROCESS] [MEDICAL_PROCESS] [DURATION] or I can't sleep [DURATION] [DURATION] [DURATION]. And so I started taking the [DRUG] and kept gargling with salt water. And then the, the [DATE] [DATE] [DATE], it was like, oh my God, my right ear is really hurting. And we were going to be going to our son and daughter in law's in [LOCATION] [LOCATION] for [EVENT]. So I thought, well, going to just go to [ORGANIZATION] [ORGANIZATION] and get checked out. And I said, well, you're not really experiencing [MEDICAL_CONDITION] symptoms because all it was was [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] and my ear hurt. And she said there was fluid in my ear, but she didn't want to give me an [DRUG]. She said it was clear and I'm like, okay. So she said, just keep taking a [DRUG]. So I was kept taking the [DRUG]. And then after [DURATION] [DURATION] [DURATION] [DURATION], [DURATION] [DURATION] [DURATION] with having all that [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] and stuff, my glands just started aching and aching and aching and they felt real tight and they were aching and the right side was the worst. And then it kind of went down in the middle of my throat and then I went over to the left side. So I went back on [EVENT] [EVENT] [EVENT] to [ORGANIZATION] [ORGANIZATION] and I said, you know, I really don't feel good. I really think I could benefit from an [DRUG]. And so it was the same person who saw me the week before. So she gave me an [DRUG]. She gave me [DURATION] [DURATION] of [DRUG]. And so after the week of [DRUG] it, you know, it helped. And I thought it was, you know, I'm like, oh good, I'm on the mend. And then I would just keep having these, this achiness in my neck and my glands and you know, a Lot of facial size, pressure and stuff. Nothing ever clogged, like, nothing like I felt clogged. I never was, like blowing mucus out of my nose or anything. And so then I decided to go see [PERSON_NAME]. [PERSON_NAME] and have her check me out, because then I was wondering if possibly the lingering part was due to her. Her having put me on [DRUG]. I had been on [DRUG] maybe [DURATION] [DURATION], not quite somewhere between [DURATION] [DURATION] and [DURATION] [DURATION] before I started getting sick. And I didn't look up any of the side effects of [DRUG] because my son says if you read that, then you think that you have those, he's a [OCCUPATION] thing. You think that you have that stuff. But I do have that stuff, some of the things it says. But [PERSON_NAME]. [PERSON_NAME] said, you know, those are just kind of unlikely symptoms. You know, I don't really think it's the [DRUG]. And my son was like, no, I don't think it's the [DRUG] either. But. So I've been staying on it, but I'm not sure if there's nothing wrong with me sinus wise. I want to go off of it for [DURATION] [DURATION] [DURATION] just to see, I guess to prove to myself whether or not it actually is a reaction to having switched [DRUG]. Okay. Because I, I have the, the achiness in the glands and like all the sinus pressure. Like, I can get up in the morning and it'll feel like. Oh, like you feel like when you're coming down with something, you know, like how your eyes and, you know, I have a lot of sinus pressure up there and I read that was one of the side effects. And. Oh, and [PERSON_NAME]. [PERSON_NAME] put me on another [DRUG] because she says, oh, I think it's just lingering sinus. Yeah. So I'll give you another [DRUG]. And I just think the [DRUG] then was masking these symptoms. And maybe I'm feeling better because if it is crest, or maybe I'm tolerating it more. But I think part of it is like, like a, like probably a pulling and a tightness in my neck and glands. And I think maybe that's what's causing that ear pressure. Because it's not ear pain, like an [MEDICAL_CONDITION] [MEDICAL_CONDITION]. Yeah. It's just more like it's pressure. I thought, well, maybe I had so many people, you know, three times people looking at my ears, maybe wax in my ears is compounded in there and needs [MEDICAL_PROCESS] [MEDICAL_PROCESS]. I don't know. I'm just frustrated because I want to Feel better because we're going to have a new grandchild next month. And I just tired of this because it's not the way I normally feel. I suffer from [MEDICAL_CONDITION] and have had so many [MEDICAL_CONDITION] [MEDICAL_CONDITION] over the years. But this is something that's just kind of a lingering, irritating symptoms. Okay. Now sometimes I'm just like, in here. Like, it's like here kind of pulls down here on the sides, and it's like, you know, I have tightness up here. And my son said that that crestor does cause tight muscles or pain in the shoulder muscles. So I don't know if maybe that I'm so tight that that's constantly tugging. And then, you know, I go to exercise or do stuff. Then all of a sudden, I just, like, you know, get more pressure in my ears because. Are you still feeling the pressure in the sinuses, too, or has that gotten better? That has gotten better, but it's like, right, you know, around in here, around the eyes. Like, I have tender spots right here, and I can feel it, you know, like, it's kind of like that. Kind of like when it. You feel like you're going to. You're coming down with something, an [MEDICAL_CONDITION] or a. Or [MEDICAL_CONDITION]. How you kind of get that? Yeah. And then, you know, after [DURATION] [DURATION] hours, it can go away. It's just. It's not like, okay, in [DATE_INTERVAL], yes, I got sick, I stayed sick, and then I got better, and it's like, well, why do I still have these things going on? Okay, so. All right, maybe don't go anywhere. I mean, I. Are you having any drainage down the throat at all [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]? A little bit, but not more than what I probably normally have. Okay. All right, well, let's get a good look and see. I. Have a seat here. Let me just hit pause on this because we don't need this recording. Next paragraph or section is [MEDICAL_PROCESS] [MEDICAL_PROCESS]. [MEDICAL_PROCESS] [MEDICAL_PROCESS]. There is a leftward nasal septal deviation present, and then the rest of the exam is normal. Next paragraph is plan or assessment. Sorry. Number one is [MEDICAL_CONDITION] [MEDICAL_CONDITION]. Number two is [MEDICAL_CONDITION] [MEDICAL_CONDITION]. Next paragraph. The patient reports the onset of symptoms on [DATE] [DATE], [DATE], including [MEDICAL_PROCESS] [MEDICAL_PROCESS] drainage, comma, scratchy throat, comma, tiredness, comma, ear pressure, comma, and the feeling like she's coming down with something, period. She has been on [DRUG] twice, but feels like they only kind of patched things over, period. She does have a history of [MEDICAL_CONDITION] [MEDICAL_CONDITION] in the past, period. She takes [DRUG] [DRUG] [DRUG] started [DURATION] [DURATION] before the symptoms came on [DRUG] [DRUG] comma and was wondering if that was causing the symptoms period. Although this isn't likely comma, I do think it should be. I do think a [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] should be ruled out before the patient makes any decision on whether or not she wants to switch back to her [DRUG] and see how she does with these symptoms period. Next paragraph is plan number one as I discuss my assessment as above with the patient number two [LOCATION] [LOCATION] comma non contrasted comma with stealth protocol to evaluate for [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] refractory to [DRUG] [MEDICAL_PROCESS] period. Contact patient with the result and plan period. If the patient's sinuses do demonstrate evidence of [MEDICAL_CONDITION] comma, we would then treat her with [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] for [MEDICAL_CONDITION] [MEDICAL_CONDITION] period. If the sinuses are normal comma, she could experiment with switching back to her original [DRUG] [DRUG] [DRUG] and see how that goes period. End of our number. 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