The most likely diagnosis is Acromegaly.
The symptoms of John are the symptoms which happens in Acromegaly. Acromegaly happens when pituitary gland makes and releases too much of growth hormone. Too much of growth hormones causes bone, cartilage, body organs and tissues to increase in size such as increase in size of hand, feet, cranium, nose, jaw, ears. It is generally caused due to formation of tumor in the pituitary gland which is known as pituitary adenoma. Treatment requires removal of tumor by surgery.
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