Patient comes in today for skin testing. She was evaluated by Dr. on 04/07/2016. She has a variety of allergic conditions that Dr. is working on. She does have significant polyps and aspirin allergy and wheezing and has been on a multitude of steroids to help control both her polyps and asthma. She now feels that she really likes to prevent need of using steroids at all and is interested in doing treatments and involved to help manage the symptoms. She also has significant nasal troubles and specific allergy triggers as well as chronic cough that may be due to asthma and postnasal drip. She has ocular symptoms as well including itching, tearing, and burning. She currently is using Flovent 220 mcg two puffs twice daily right now for asthma. She has been on Advair previously, it caused cough. Dr. has been trying to reduce her to the lowest affective dose of the Flovent and is using her albuterol daily occasionally as well. She also has a variety of foods that seem to cause her troubles, but only if she eats too much of certain things. Dr. discussed with her aspirin desensitization therapy and we discussed allergy immunotherapy to help reduce her triggers and otherwise no other changes.
1. Samter’s triad nasal polyposis, aspirin-sensitivity, and asthma.
2. Allergic rhinitis.
3. Allergic conjunctivitis.
4. Concern for food allergies.
1. At this time, I have suggested that she did go see Dr. again to manage her treatment as she will make an appointment in a few weeks’ time to see her after she takes a trip to Twin Falls. She did get started on QNASL at last visit. She does state that has helped a lot and she can finally taste and smell again and that makes her very happy.
2. We did discuss that I think she would be a great candidate for aspirin desensitization as well as possible allergy immunotherapy to reduce her triggers and reduce her recurrence rates of her nasal polyps in the future. She is going to consider all these techniques and discuss her options with Dr. when she gets back.
3. We will follow up in three weeks’ time.