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  "text": "This patient is [PERSON_NAME] [PERSON_NAME]. [PERSON_NAME]. Date of birth is [DATE_OF_BIRTH], [DATE_OF_BIRTH]. [DATE_OF_BIRTH]. Is it working? So far they're using humans to still transcribe, but they're apparently going to be able to teach the computer how to recognize what's important and what isn't, which I have no idea how it does it, but we'll see. What's been happening? Well, when I called for the appointment, the main thing that was like this tickle in my throat, but it would come out of. No, I've had it for kind of like [DURATION], but it was getting worse. And it's like I can't even want to. I don't even want to go to church anymore because I'm sitting in the sermon and he's talking. All of a sudden I'll feel this come on. And I just get this urge to cough. And the only thing that helps is [DRUG] [DRUG] [DRUG], if I can get them in fast enough. But it's just like this spasm. Okay, and is that something that. That you've. Does it come and go or is it always present to some degree? Yeah, it kind of comes and goes. I always notice that something's there. Just sometimes it. All of a sudden it will get worse. Okay, and do you feel this daily? Basically, pretty much. Okay. I can usually just cough a couple of times, but at church I try not to, but of course, then I don't. More I try not to, the more I want to. Right, exactly. It's kind of embarrassing. So I thought that's it. I've had it. And that's been going on for a while. Okay. I've had [MEDICAL_CONDITION] [MEDICAL_CONDITION]. I have drainage. Every morning I wake up, you know, I know that I have [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION], but I also have. I want to get your thoughts on some [DRUG] [DRUG] that will stop this. So I can go to church. Right. Listen to what's going on, as opposed to. [PERSON_NAME], please don't let me start coughing. Yeah. Okay, well, how about frequent throat clearing? Like, do you have any type of a foreign body feeling in your throat like something's in there or a fullness or. No, not really. Just like I wanna. And when you swallow, does food slow down, need washing through, or does it stick or anything? Or do you feel. No, sometimes it does if I eat like bread, but that's know. Then I'll take a big but that's like I can feel this pressure. That's different than what I think. I probably have a little Whatever. Okay. And do you get any heartburn at all? No. Okay. Do you have [MEDICAL_CONDITION] [MEDICAL_CONDITION] at all that you know of? Not particularly. I. I've taken [DRUG] like [DRUG] and stuff like that, thinking that might help dry up the sinuses to stop the cough. It does help a little. Okay. How about [MEDICAL_CONDITION] [MEDICAL_CONDITION] at all? Only here. Forehead in the sinuses area. Right. Right in there. Okay. Nasal blockage, difficulty breathing. I think my left side is blocked. My right side seems to pretty good. My left side is blocked frequently, but I can blow it out, but nothing comes out. Okay. Yeah, nothing comes out, but it just kind of helps. When I get up in the morning, this side's blocked, but then it kind of drains and clears as the day goes on. Okay. How about blowing stuff out the front of the nose? Otherwise, very little. Very, very, very little. And then pressure or popping in your ears at all? My ears both hit by ringing in my ears, especially on the left. My right ear. It's funny, if I take a shower or something, it gets all clogged. It takes a while to get rid of it. Okay. By a while. I'm talking maybe [DURATION] [DURATION] or something. Yeah. Okay. And then in terms of things that you've tried. So then for this, the [DRUG] [DRUG] help. Yeah. The [DRUG]. Doesn't sound like it kind of helps a little bit, but I still end up with this feeling. Yeah. That I want to cough. I have tried [DRUG]. I was going to ask about that too. Yeah, I have. That was recommended [DURATION] ago by [PERSON_NAME]. [PERSON_NAME]. When I saw him, I didn't know if I could use that forever. It's actually safe to use long term. I mean, because it's been long term for me. Yeah. Okay. And I don't know if that helps or not. It might. I was using [MEDICAL_PROCESS] [MEDICAL_PROCESS], but, you know, I didn't feel like I really needed to. Yeah, I didn't know about that. Okay. And I thought, you know, I don't know, I'm [MEDICAL_PROCESS] this stuff up there. Maybe that's not such a good idea. Okay. And when was the last. Generally speaking, when do you think the last time you used the [DRUG] was, like [DURATION] [DURATION] ago or. No, it's probably been in with maybe [DURATION] [DURATION] or so when I tried to use it, but then I tried to and I didn't use it regularly. It's just. I would try to remember. But then my nose started having some bleeding. Bleeding. Okay. Not a lot, but just enough that I thought, well, I better lay off and let it heal. I'M taking [DRUG] too. Okay. It wasn't gushing. It was just very light pink drainage. I'm sure. And it was so dry. Of course, that was just recently. Okay. When I say recently, I'm talking about in. I'd say [DURATION] [DURATION], [DURATION] [DURATION] [DURATION] [DURATION], maybe [DURATION] [DURATION]. Okay. And how about your hydration? How do you feel? I probably don't drink enough water. Okay. I probably don't. Okay. And then. Anything else that you wanted to mention at all? No, just the ringing in my ears. And then especially the reason I came was because this tickle. Yeah. And I. I thought, well. And I. I'm a [OCCUPATION]. Or was. I [OCCUPATION]. Oh, great. Okay. I worked at the [ORGANIZATION] [ORGANIZATION], a [OCCUPATION]. Anyhow, so I've been reading on this and I thought, well, maybe I've got a polyp over here or something like that, but I'm not doing anything with it, so. But I just needed your advice. What are your thoughts on what I could do to make this more bearable? Yeah, definitely. And another funny thing is, and if I'm having a glass of wine, if I drink red wine, all of a sudden I have to, it irritates my throat. Okay. White wine doesn't. I don't know if that's any great medical discussion discovery, but does it make the cough worse or the throat clearing worse at all? No, it's just for the first swallow or so. And I drink a swallow of water and I'm fine. Okay. All right, we'll take a look. That's my story. Let me get this paused. Okay. [MEDICAL_PROCESS] [MEDICAL_PROCESS]. It is normal. Next paragraph is chronic throat. Next paragraph is assessment. Chronic throat clearing, cough, tickle. Next line. This symptom has been present for [DURATION], comma, where the patient has a tickle in the throat with an urge to cough, period. She also does have chronic throat clearing and post nasal drainage, which she attributes to [MEDICAL_CONDITION] [MEDICAL_CONDITION], period. There is a history of [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION] as well, for which she has seen [OCCUPATION] at least over [DURATION] [DURATION] [DURATION] [DURATION] ago, period. [MEDICAL_PROCESS] [MEDICAL_PROCESS] is normal. Next paragraph. My differential diagnosis includes laryngopharyngeal reflux, comma, [MEDICAL_CONDITION] [MEDICAL_CONDITION] [MEDICAL_CONDITION]. Open parent. The patient denies [MEDICAL_CONDITION] [MEDICAL_CONDITION], close, paren, comma and [MEDICAL_CONDITION] [MEDICAL_CONDITION], period. Next paragraph. Plan number one is [DRUG], [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [DURATION] [DURATION], trial period. If there has not been a significant improvement, the patient will call us and we will recommend [DRUG] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS] [MEDICAL_PROCESS]. Bid for [DURATION] [DURATION] period. If this does not result in any improvement, comma, we would then move with move forward with maximum [MEDICAL_PROCESS] [MEDICAL_PROCESS] for [MEDICAL_CONDITION] [MEDICAL_CONDITION] involving a [DURATION] [DURATION] course of [DRUG] [DURATION] [DURATION] [DURATION] [DURATION] [DRUG] taper period. Follow up would then be based on how she's doing, period and of patient thinks.",
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