Patient is here today to do a recheck on his immunotherapy. He currently has been on immunotherapy for about 18 months. He is doing very well. He states that he has had marked reduction in nasal congestion and mouth breathing and eye irritation. He had significant problem before during the immunotherapy and ever since he began he has progressively gotten better. He feels that this has been a treat treatment. He does not need any medication such as over-the-counter antihistamines or nasal spray to help with any breakthrough allergy symptoms. He has been doing every two week injections for the last six months and today he is interested going to every four weeks injections to continue his treatment as this will help with his work schedule. He denies any problems with sinus infection or respiratory infections since we saw him last. He does have history of sleep apnea. He uses a BiPAP machine for this and he is able to tolerate this due to reduction in his congestion very well. He does say he gets some minor irritation locally from injections. I encouraged him to use over-the-counter antihistamines as needed to help reduce this irritation and he says he will try.
1. Allergic rhinitis.
2. Allergic conjunctivitis.
3. History of mild intermittent asthma.
1. At this time, we will go ahead continue the allergy immunotherapy and extend his frequency to monthly injection. He states that he has about 8 to 9 shots left in his vial and we will see him again in six months time when he needs a refill.
2. He was encouraged using antihistamines before injection to help reduce any local reactions on the arms and or if he has any breakthrough symptoms. He will let us know if he is having increase in allergy symptoms with the new extended immunotherapy schedule.
3. We will follow up in six months time or sooner if he needs any advice on how to maintain his allergy symptoms.