{ "text": "This patient is [PERSON_NAME] [PERSON_NAME]. Date of birth is [DATE_OF_BIRTH], [DATE_OF_BIRTH]. So. Well, tell me what's. What's brought you in? Oh, it's been an interesting year. So I. My ears have been ringing since last [DATE_INTERVAL]. Excuse me? Last [DATE_INTERVAL]. I thought it was from Fine. Then I thought it was for my [DRUG] [DRUG] [DRUG]. Then I went to see [PERSON_NAME]. [PERSON_NAME], I want to say, in the fall. And I said, you know what? They're still ringing. It's driving me nuts. I have really bad [MEDICAL_CONDITION]. I've had it my whole life. I've had [MEDICAL_PROCESS] [MEDICAL_PROCESS] once. I was told to have [MEDICAL_PROCESS] [MEDICAL_PROCESS] again, and they were going to have to [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] and I didn't do it. So I pop [DRUG] cold and sinus to kind of unplug my ears. They get plugged a lot. They just feel full. Yeah. And so they're ringing, ringing, ringing, ringing. She recommended that I try [DRUG] and do that twice a day to see if that doesn't open it up. I've always switched back and forth. I've always used [DRUG]. I think it's nasal cord. Okay. But I didn't. You. I haven't used [DRUG]. So I tried the [DRUG] for a while, that did nothing. And so then I said, okay, now I gotta go see an [MEDICAL_PROCESS] guy because this is driving me crazy. And then last week I ended up in the [ORGANIZATION] [ORGANIZATION] at [ORGANIZATION] because my [DRUG] [DRUG] went out of sync and now I have a [MEDICAL_PROCESS] [MEDICAL_PROCESS] monitor on and they told me I missed beats, whatever that means. That's a whole separate issue. Okay. Okay. So that's my history in a nutshell. All right. They took the [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Yeah. And she said, believe it or not, you've got [MEDICAL_CONDITION] [MEDICAL_CONDITION] and you probably need hearing aids. I've said my [PERSON_AGE] year old mother doesn't have hearing aids and hearing aids. Well, there's two, two reasons to get hearing aids. One of them would be if you're having problems. Right. So if you don't feel like you're having problems, then there's no reason to get them. The other reason is when you wear hearing aids, it does reduce ringing while you're wearing them. So that would be the one applicable reason in your case, if you feel like your hearing is otherwise okay. Right. That's what you said. It'll stop your ringing. Yeah. Just while you're wearing it though, right? Yeah. Correct. Now, is it high pitch, low pitch, middle pitch? Is there a pitch? It will sometimes and this is very sporadic. There's a very high pitch. A very high pitch. Most of the time it's just like they're doing it right now. It's just a low ring. It's more my right ear than I think it is my left ear. But I'm not 100% sure on that. I do. You know, I sleep with white noise all the time. I always have, so it doesn't bother me when I sleep. I have no problem with that. But they'll just ring. Sometimes they'll ring [DURATION] [DURATION]. Sometimes they'll ring, you know, on and off. And some days they don't ring at all. Okay, Anything like a pulse to the ringing at all? Like a heartbeat? Okay. Anything that you've noticed makes the symptom worse at all, the ringing worse. And anything that helps it besides, like masking it? I mean, I walk on and I do this. I'm like, okay, I'm ready. If you do this, it'll make it go away. I'm like, no, that doesn't work. Okay. And how about your hearing? Do you feel like you have [MEDICAL_CONDITION] [MEDICAL_CONDITION]? I told the woman when I went in, I know that if women are speaking softly, well, these masks don't help. Yeah. Because I realized how much I read people's lips now that we're wearing masks. I'm like, okay, I'm not hearing like I used to, but I think I was reading lips so much, I didn't realize, like, if it's. If a woman is speaking very softly, I do have a hard time hearing that. I always have to say, could you speak up? Okay. And then any history of noise exposure at all? Loud noise exposure? Like all [PERSON_AGE], you went to concerts all the time. You stood in front of speakers. That would be the extent of it. I work in a manufacturing plant, but it's really not that loud. Okay. And I'm not on the plant 24 7. You know, I'm out in spurts. So I. I don't attribute it to that. Okay. Okay. And then did the [OCCUPATION] talk to you about, like the different mechanism, not coping mechanisms, but like ways to work with [MEDICAL_CONDITION] at all. She gave me this [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Okay. Piece of paper. And then I have an appointment, a follow up appointment with her at the [DATE_INTERVAL] [DATE_INTERVAL] [DATE_INTERVAL], I think. Oh, good. Okay. I am amazed to find out what hearing aids cost. Yeah, that was a shocker, right? Exactly. They can be. Yeah. Pretty. Pretty steep. Right? Right. But yeah, I almost fell over. I'm like, and how much does insurance not pay for this. Right, Exactly. Insurance is really good at not paying for it. Right? Yeah. Because. Yeah. There's no benefit to them. No, absolutely not. Right. Okay. So. Yeah, I'll pause this because this doesn't need to. Maybe I will pause this. There we go. Okay. Next pair or next section is [MEDICAL_PROCESS] [MEDICAL_PROCESS] and everything is normal. So please check all the normal boxes. Next paragraph. Number one is Next. Geez, I'm so sorry. Next section is [MEDICAL_PROCESS]. Number one is [MEDICAL_CONDITION] [MEDICAL_CONDITION], bilateral. Number two is sensorineural [MEDICAL_CONDITION] [MEDICAL_CONDITION] bilateral. Next paragraph. The patient notes the onset of [MEDICAL_CONDITION] [MEDICAL_CONDITION], which is a low ringing pitch since [DATE_INTERVAL] [DATE_INTERVAL] after an airplane flight period. It is somewhat louder on the left or on the right than the left, period. It is not constantly present, but when present can be quite noticeable, period. She uses white noise during sleep, but does report that during the day the [MEDICAL_CONDITION] can be bothersome to her, period. The next paragraph. [MEDICAL_PROCESS] [MEDICAL_PROCESS], [DATE] [DATE], [DATE] demonstrates a moderate high frequency loss on sensory neural loss on both sides with upsloping to mild loss at the highest pitches, period. This does have a configuration of [INJURY] [INJURY] [MEDICAL_CONDITION] [MEDICAL_CONDITION], but the patient does not have any significant noise history, period. The [MEDICAL_CONDITION] could be central. Could be central compensation for the [MEDICAL_CONDITION] [MEDICAL_CONDITION], although I would have expected more of a high pitch period. She has already been on [DRUG] for potential [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] with no improvement, period. This is most likely [MEDICAL_CONDITION] [MEDICAL_CONDITION], period. Next. Number next is chronic history of [MEDICAL_CONDITION] [MEDICAL_CONDITION]. Number next is history of [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Next paragraph. Plan number one. I reviewed the [MEDICAL_PROCESS] [MEDICAL_PROCESS] results with the patient and discussed my [MEDICAL_PROCESS] as above. Number two, I discussed that there is no cure for [MEDICAL_CONDITION], period. However, comma, she should look into [MEDICAL_CONDITION] [MEDICAL_PROCESS] if she is having any issues with it, period. Additionally, comma, hearing aids could potentially be of benefit, comma. And an optimal situation would be for her to have a trial of hearing aids if possible to see if it. If it worked with the. If they work with the [MEDICAL_CONDITION], period. She does not have enough subjective [MEDICAL_CONDITION] [MEDICAL_CONDITION] to feel like she needs hearing aids for that reason, period. Number next is her correction. She is medically. She is medically cleared for hearing aids though, period. Number next is return to clinic when needed. End of patient. 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