[doctor] hi , alexander . how are you ?
[patient] i'm doing really well . thank you .
[doctor] so , i know the nurse told you a little bit about dax . i'd like to tell dax about you . okay ?
[patient] sure .
[doctor] so , alexander is a 62-year-old male , with a past medical history significant for reflux , who presents for follow-up of his chronic problems .
[doctor] so , alexander , what's being going on ?
[patient] well , i am so thankful you put me on that medicine for my , my reflux .
[doctor] the protonix ?
[patient] the protonix . that , i had , w- made an amazing change in my life .
[doctor] yeah .
[patient] i'm really comfortable now . i eat whatever i want , and i feel so much better .
[doctor] okay , great . i'm glad to hear that . i know you were having a lot of discomfort there before , so that's good . okay . and how are you doing , kind of , managing your diet ? i know , you know , you have to do some lifestyle modifications , like cutting back on caffeine and spicy foods and alcohol . how are you doing with that ?
[patient] i'm doing really well . i moved over from caffeine , over to green tea .
[doctor] okay .
[patient] and it , it is so , m- it does n't cause as much problem as it did with , when i was drinking so many energy drinks a day .
[doctor] all right . good . i'm glad to hear that . great . all right .
[patient] uh , i think getting that , rid of that reflux , really helped my attitude improve .
[doctor] okay .
[patient] uh , my job's going great . everything's phenomenal right now .
[doctor] okay .
[doctor] okay . and you have a , a good support system at home ? i know you have a big-
[patient] yeah .
[doctor] . family .
[patient] yes . yes . all my kids-
[doctor] okay .
[patient] . call and check on me every day .
[doctor] okay . great . i'm glad to hear that . now , i know you did a review of systems sheet when you checked in .
[patient] yes .
[doctor] i , are you having any symptoms ? any chest pain , shortness of breath , belly pain , of , nausea or vomiting ? anything like that ?
[patient] no . no symptoms at all .
[doctor] okay , great . um , well , let me go ahead . i wan na do a quick physical exam .
[doctor] hey , dragon . show me the vital signs .
[doctor] so , your vital signs here in the office look really good . so , you're doing a great job managing your , your blood pressure . your heart rate's nice and low . i'm gon na go ahead and take a listen to your heart and lungs .
[patient] okay .
[doctor] and i'll let you know what i find . okay ?
[patient] okay .
[doctor] okay . good . all right . so , on physical examination , i , i do n't hear any carotid bruits in your neck , which is really good . you know , your heart exam , i do hear a slight 2/6 systolic ejection murmur , which i've heard in the past , so that's stable . uh , your lungs are nice and clear , and you do have , you know , 1+ pitting edema bilaterally in your lower extremities .
[patient] okay .
[doctor] so , what does that mean ? you know , i , i think , you know , you're doing a ... it sounds like a doing a good job watching your diet . you could ... you just are retaining a little bit of fluid , maybe just from standing all day .
[patient] okay .
[doctor] okay ? let's take a look at some of your results . okay ?
[patient] okay .
[doctor] hey , dragon . show me the endoscope results .
[doctor] so , this was the endoscopy that you had last year when you were having all that pain . it just showed that you had had some mild gastritis . so , it's good to hear that that , you know , protonix is helping you a lot . okay ?
[patient] okay .
[patient] i'll do a little more exercise too .
[doctor] that sounds great . all right . so , let's talk just a little bit about , you know , my assessment and my plan for you .
[doctor] for your reflux , i want you to continue on the protonix 40 mg a day , and continue with those lifestyle modifications with the dietary stuff-
[patient] okay .
[doctor] . okay ? do you have any questions ?
[patient] no questions .
[doctor] okay . all right . well , the nurse is gon na come in soon , and she's gon na check you , get you checked out . okay ?
[patient] okay . thank you .
[doctor] hey , dragon . finalize the note .

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