{ "text": "Next patient is [PERSON_NAME] [PERSON_NAME]. [PERSON_NAME]. Medical record number [HEALTHCARE_NUMBER]. Turn this thing on. Okay, so go ahead and tell me what has got you here. What got me here is my [MARITAL_STATUS] [PERSON_NAME] has told me for many [DURATION] that I have [INJURY] [INJURY]. And she had me go see a. Not a [OCCUPATION], but a guy by the last name of [PERSON_NAME], who's a hearing type guy. Yeah, hearing aids. And he did some tests on me about [DURATION] [DURATION] ago and he gave me this little note here. Airborne Gap [MEDICAL_PROCESS] 500k, 1k only, not [MEDICAL_PROCESS] 2k, whatever that means. Yeah. Okay, so. And that's why I came and he suggested seeing somebody such as yourself. Okay. To get evaluated, see if I have any issues. Very good. Now, do you notice any difference between the ears [MEDICAL_PROCESS] all? Does one ear seem worse than the other? I don't really notice it, but both he. He had said it was a left ear seemed to little worse than the right ear. Okay, how about any ringing noises, buzzing, anything like that? Like frequent [MEDICAL_PROCESS] least? No, there's no ringing, there's no buzzing. No, nothing like that. Once in a while when I bend over, especially like early [MEDICAL_CONDITION] [MEDICAL_CONDITION] morning, I'll have some just like an equilibrium issue type, but nothing goes right away. Okay, but it's something I didn't have in my younger [DURATION]. Yeah. So it's a little different. Okay, and how about other ear symptoms? Like ear pain [MEDICAL_PROCESS] all, a pressure like feeling or plugging discharge coming out [MEDICAL_CONDITION] [MEDICAL_CONDITION] ears and all [MEDICAL_CONDITION] [MEDICAL_CONDITION] as an adult, [MEDICAL_PROCESS] [MEDICAL_PROCESS], [INJURY] [INJURY]. Okay. And let's see, I'm told I like to listen to the TV too loud. Okay. Those types of things. Well, I. I guess. Yeah. The big question too. Or did I ask about noise exposures, by the way? I don't think I did. You didn't? I've had noise exposures when I was in college, very loud concerts, A couple, you know, that were. They felt too loud when I was there. Yeah. And then some gunfire that seemed loud. Just when I was a kid where I was around people shooting shotguns and stuff. And a few other times since then, but very rarely. But the gunshots, that always bothered me. So I tried to stay away from that as much as possible. Okay. And then with respect to your hearing, do you find it to be [MEDICAL_PROCESS] a problematic enough point where you would want to get hearing aids or. That's one [MEDICAL_CONDITION] [MEDICAL_CONDITION] big questions. I guess I'd consider those if it really would improve the quality of my life. I noticed I'm having to ask her what? Quite a bit. What. What did you say? What did you say? And sometimes I don't hear everything that some [MEDICAL_CONDITION] [MEDICAL_CONDITION] little kids say. Usually when men are speaking, I hear most of that kind of stuff. Okay. So. Okay. Because. Yeah. The decision to get hearing aids is really based on how problematic you find the loss. So if it's something where you're thinking, gosh, I'm kind of sick of this, or maybe everyone else is sick of it, that makes me sick of it too. I'd like to get hearing aids, then that's the right choice. On the other hand, if things are okay and you're like, well, I don't know yet, then that usually means waiting. So. Yeah, but it really. Yeah, it just depends on the. The negotiation in a way. And also kind of like, in general, like, the negative impacts it has. Yeah. So on you or others? I'm not sure. The other condition, which would be that she would also need a [MEDICAL_PROCESS] [MEDICAL_PROCESS]. I'm not sure she's up for that, even though she's insisted that I have all this. Well, I guess to be fair, we're teaming up on you now. And I could get myself in trouble for this. No, he definitely has trouble hearing me and. And our grandkids too. It's hard. Yeah. So. Yeah. Okay. Maybe if you could try out. Try hearing aid for. See if he likes it or if it's possible or if you think. Whatever you think. Yeah. I mean, it really. Opinion. Yeah. It really comes down to. To you. Yeah. Yeah, I might. I think they have them where you can test them for a period of time, hopefully. Yeah. See what. See if he allows you to like them. Yeah. Before you invest them. Right, exactly. Yeah. See if they have trial ones. Yeah. Yeah. So. And then the [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Right. So there is like a little bit of what's called a [INJURY] [INJURY] [INJURY]. There's. Which is not bad. There's [STATISTICS] types of [INJURY] [INJURY]. There's [MEDICAL_CONDITION] [INJURY] [INJURY] [INJURY] [INJURY], which all of us get as the nerves just start to degenerate over time and we hear less, especially [MEDICAL_CONDITION] [MEDICAL_CONDITION] high pitches. And then there's the [INJURY] [INJURY], which is the hearing bones, the eardrum, the ear canal, like the mechanical aspects [MEDICAL_CONDITION] [MEDICAL_CONDITION] vibration of sound. And on this test, actually, it looks pretty good. You do have some [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_PROCESS] the highest pitches. So on the left, [MEDICAL_PROCESS] the three highest pitches, the ear is a lot worse than the right. The clarity is really good, though. It's 96% and 92%, meaning when she turned it up loud enough to hear comfortably, your clarity was. Was good. Which is a good omen for hearing aids if you decided to do it. Because some people, their clarity is terrible, which means you could turn up the volume as loud as you want. It's going to be unclear and garbled and awful. And that's why some people call them expensive paperweights, because. Yeah, because their clarity stinks. And. But someone sold them hearing aids. Okay. So with that [MEDICAL_CONDITION] present, there is. There's like, a really rare cause of [MEDICAL_CONDITION], which is a growth on the hearing nerve which can just continue to grow over time and make things a lot worse, but really slowly. I recommend another [MEDICAL_PROCESS] [MEDICAL_PROCESS] in [DURATION] [DURATION] just to see if there is any more loss on that left side. Because if that were the case, where the left side was just dropped, bottoming out, and the right side was staying stable, then we get an [MEDICAL_PROCESS] to make sure there wasn't one there of those growths. But it's so uncommon. And normally the ears look a lot worse on the [MEDICAL_PROCESS] [MEDICAL_PROCESS] than this. So. Yeah. Okay. But I think a [MEDICAL_PROCESS] [MEDICAL_PROCESS] in [DURATION] [DURATION] would be a good idea. Okay. So. Okay, let me take a growth with this ear. So it's called an [MEDICAL_CONDITION] [MEDICAL_CONDITION]. So it's [MEDICAL_CONDITION] [MEDICAL_CONDITION] of hearing that comes off the brain stem before it enters the bone [MEDICAL_CONDITION] [MEDICAL_CONDITION] ear itself can grow a little nodule. It's like a. It's not a [MEDICAL_CONDITION] or anything like that. It's just a. An [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] sheath [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] itself. And over the course of, like, [DURATION] and [DURATION], it can grow a millimeter [MEDICAL_PROCESS] a time and slowly just start to expand and [INJURY] [INJURY] hearing. Okay, so. And if there was something like that, is it [MEDICAL_PROCESS] [MEDICAL_PROCESS], typically involved [MEDICAL_PROCESS], or. Yeah, okay. Yeah. But that being said, In [DURATION] [DURATION], I found [STATISTICS] people with those out of three, several hundred, who have the [MEDICAL_CONDITION]. So it's really uncommon. Yeah. And normally they have a big difference between both ears. So where one is just [MEDICAL_PROCESS] and the other one looks normal, and you're like, okay, there's something going on here. Yeah. Okay, so. But let me get my hands washed, and we'll take a look in your ears, nose, and throat. Is there any type of hearing aid that you think is better than others? I actually don't have an opinion on that. I typically. Because everybody sells a different brand, and I don't get to work with that aspect [MEDICAL_CONDITION] [MEDICAL_CONDITION] care of hearing aids. So I'll have people who are provided whatever hearing aid they got [MEDICAL_PROCESS], whatever person, whether it's [ORGANIZATION] or [PERSON_NAME] or [ORGANIZATION] or wherever. And I mean, yeah, it's really. They don't ever really find out. Yeah. Like which is the best. You can look it up online and any company is going to say that they're the best. So it's so hard to. And the whole problem with, with review product reviews is that every person is different. So for instance, that person who got the hearing aid who has 40 clarity. Well, it's not the hearing aid's fault, it's the person who sold it to them. Yeah. So they're going to put a horrible review in. Say this hearing aid is junk, it doesn't do anything because they shouldn't have got it [MEDICAL_CONDITION] [MEDICAL_CONDITION] first place, which they don't know. So. Yeah. So it's kind of, I think if. As long as it's one [MEDICAL_CONDITION] [MEDICAL_CONDITION] main accepted brands which people carry around here. I don't know of any that carry the. Well, I guess [LOCATION] doesn't exist anymore. But it may be [NATIONALITY] brand of hearing aid this big and coal powered. And you know those, those don't exist. So it looks good. Okay, take a look in your nose next. You can go ahead and take your mask down. Okay. How's the nose look? So the septum is kind of crooked. The cartilage [MEDICAL_CONDITION] [MEDICAL_CONDITION] middle, it deviates to the right [MEDICAL_PROCESS] the bottom [MEDICAL_CONDITION] [MEDICAL_CONDITION] septum, then it goes across to the left side and narrows the left and then it comes back up straight again. That. Okay. So but if, if you don't have problems breathing. I don't have problems breathing. I have problems snoring probably a little bit. Would there be any reason to correct that to eliminate the snoring? I probably wouldn't get rid [MEDICAL_CONDITION] [MEDICAL_CONDITION] snoring. Okay. Unless you were saying I can't breathe [MEDICAL_PROCESS] all. Yeah. And in those cases. Those cases it could help. Yeah. Okay, let me [MEDICAL_PROCESS] [MEDICAL_PROCESS] throat real quick too. Sorry about that. Oh yeah, no problem. Good. Then go ahead and say ah, great. Good. Now I'm just going to [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. You can bring it up again. Yeah, that's totally fine. Thank you. So a couple little ones. That's normal. Good. Okay, let's watch one more time here. Okay. See? So yeah, I think the follow up [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_CONDITION] [MEDICAL_CONDITION] year would be a good idea. Okay. You could do that here or you could do it with the other [OCCUPATION] and just business newski and have it sent to me. Okay. It's up. Up to you. That's. You're definitely. I think wi said that we needed a note from you that he. Oh. For medical clearance. Yeah. Okay, so this earphone gap thing he was talking about, do you know what that is? Yeah, that's the [INJURY] [INJURY] [INJURY]. And. Yeah, then you just have a [INJURY] [INJURY] [INJURY] the middle pitches in one pitch, but that's totally okay. Okay. Yeah. So let me write this here, and I'll give you this. Try to use good handwriting. This is tough. Wow. Okay. Today's the [DATE], I imagine. Okay, There we are. Great. And so, yeah, I would say if you have just. Oh, actually, let me put a little note. [DURATION] [DURATION]. Follow up. Fu is follow up. So just so you know. Audiogram, please. So, yeah, that'll just mention that. That. Can I write just what that thing was that you mentioned? Here, let me. Yeah. Oh, am I gonna give this to him? Yeah. Or we can. I can give you this one. Okay. Yeah. Acoustic. A C O U S T I C. Neuroma. [MEDICAL_CONDITION] E [MEDICAL_CONDITION] [MEDICAL_CONDITION] O [MEDICAL_CONDITION] A, I believe. [MEDICAL_CONDITION] E [MEDICAL_CONDITION] [MEDICAL_CONDITION] O [MEDICAL_CONDITION] A. Yeah. Okay. Yeah. Two cases and hundreds. Hundreds. Okay. And what was that you said again? It's like a growth [MEDICAL_CONDITION] [MEDICAL_CONDITION] sheath [MEDICAL_CONDITION] [MEDICAL_CONDITION] hearing nerve. Growth. I don't have it, but [MEDICAL_PROCESS] least I know that. Yeah. When my daughter started asking me. Okay, I'm gonna get this all. I want something totally stupid. Check. Okay. I'll steal this from here. They said he had a bunch of wax in his. Yeah, totally clear. It's so. So there's. It's like. Must have come out. Yeah. Okay. Okay. Oh, good. Yeah. Okay. Not [MEDICAL_PROCESS] all. Good, Good, good. Okay. Well, thanks for seeing me. Definitely. Did you want to. Yeah, I just had a question. So I saw you. Because I felt like I had a lump in my neck or something. And then we decided that nothing was there. But ever since then, like, sometimes when I put my head down or to the side, like, it. Like, it feels like there's a pain in there. Like. So I didn't. I mean, I had a [MEDICAL_PROCESS] [MEDICAL_PROCESS] and. You looked over the [MEDICAL_PROCESS] [MEDICAL_PROCESS] last [DATE_INTERVAL]. It's not always, but sometime. And I can't, like, repeat the movement. But does it feel like it's in your throat or does it feel like it's outside? Like in. Like in my neck? Huh. Is it behind the artery? In, like, deeper in there? So it's behind the artery in here? Yeah. Yeah. I mean, I don't feel. You don't feel it per se. Like, I mean, she complains about it quite a bit, so she's sure that there's something wrong. I don't feel any lump lumps or unusual [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] all. Sometimes we can feel our thyroid cartilage here because it has these little horns that come off it. It's more like this area. Yeah. The thyroid cartilage runs from there to there. Here, this way and then down this and then back this way. Yeah. And it has a horn on it. Sometimes that horn can. Can tug on ligaments or maybe actually be felt. But yeah, I don't feel any lump. Okay, so that's. Yeah, that's what you had said [MEDICAL_PROCESS] the time. And then. Yeah. And it. Cuz this carotid was closer than this other one you said. To the top [MEDICAL_CONDITION] [MEDICAL_CONDITION] skin. Yeah, exactly. To the surface. Yeah. So it's just something to live with. Yeah. It's like a mechanical phenomenon. Yeah. Yeah. Thanks for watching. Yeah, sure, thanks. Because I didn't know if I should come back or if I got your hands of any kind. Yeah. Or what to do about it, but. Yeah, just something weird that all of a sudden. Yeah, I get weird stuff like that too. So I understand what you're talking about. I get a weird click. Actually, it's a mechanical click in here. Yeah. It must be the. That horn of that cartilage bumping against another bone called the hyoid bone up there. And if I do it in certain directions. Yeah, certain directions that I. It's what brings those structures closer together to rub or pop. So. Yeah. Yeah. I don't hear anything, but I feel it. Okay. Yeah. Does that make sense? Just another thing. But it's definitely okay. Thank you for checking me. I appreciate it. Yeah, by all means. Happy [EVENT] [EVENT]. Thank you. You too. All right, see you. Take care. Yeah, you too. Okay, thank you. Then this door right here. Yeah, just go diagonal to the left. I'll take you right up to the elevators. Thanks. Yep. Bye. Bye. Get the door for you. Bye. Okay, next paragraph is [MEDICAL_PROCESS] [MEDICAL_PROCESS]. [MEDICAL_PROCESS] [MEDICAL_PROCESS]. There is an inferior nasal septal deviation to the right and a superior nasal septal deviation to the left. Then the remainder [MEDICAL_CONDITION] [MEDICAL_CONDITION] exam findings are normal. Next paragraph is [MEDICAL_PROCESS]. Number one is [INJURY] [INJURY] [INJURY] [INJURY] [INJURY]. Spacebar, hyphen, spacebar left and number next is [INJURY] [INJURY] [INJURY]. Base bar, hyphen, spacebar [MEDICAL_PROCESS] one frequency bilaterally. Next paragraph. The patient was referred by a [OCCUPATION] [OCCUPATION] for medical clearance. Period. A conductive loss was noted, period. The patient's [MEDICAL_PROCESS] [MEDICAL_PROCESS] is normal and I do not think the conductive loss is significant, period. However, [PERSON_NAME], there is [MEDICAL_CONDITION] of over 20 decibels [MEDICAL_PROCESS] the three highest pitches tested, [PERSON_NAME], and the word recognition is slightly worse on the left than on the right, period. The patient has no tinnitus, period. The chance of this being a [INJURY] [INJURY] is quite low, period. However, [PERSON_NAME], I do recommend follow up [MEDICAL_PROCESS] [MEDICAL_PROCESS] in [DURATION] [DURATION] period. Next paragraph Plan number one. I discussed my [MEDICAL_PROCESS] as above with the patient and his [MARITAL_STATUS], period. I also went over the [MEDICAL_PROCESS] [MEDICAL_PROCESS] results with them period. Number next is the patient is medically cleared for hearing aids number. Next, I recommended the patient get a follow up [MEDICAL_PROCESS] [MEDICAL_PROCESS] in [DURATION] [DURATION] to evaluate the [MEDICAL_CONDITION] [MEDICAL_PROCESS] the highest pitches, period. If there was a significant decrease on the left compared to the right [PERSON_NAME], this would push the issue of getting [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_PROCESS] period. However, [PERSON_NAME], as I said above, [PERSON_NAME], the likelihood of there being a [INJURY] [INJURY] is quite low, period. That said, [PERSON_NAME], I would like the results forwarded to me from the [OCCUPATION] for review and I put a note to the [OCCUPATION] to state as such period. Number next is return to clinic when needed and as above end of patient. 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