,HISTORY OF PRESENT ILLNESS: , This is a very active and pleasant 82-year-old white male with a past medical history significant for first-degree AV block, status post pacemaker placement, hypothyroidism secondary to hyperthyroidism and irradiation, possible lumbar stenosis. 
,HISTORY OF PRESENT ILLNESS : , This is a very active and pleasant 82 - year - old white male with a past medical history significant for first - degree AV block , status post pacemaker placement , hypothyroidism secondary to hyperthyroidism and irradiation , possible lumbar stenosis .