Deviated nasal septum

Patient comes in today for a followup of his recent new patient check-in on 09/01/2015. At that time, he had chief complaint of itching and watery eyes, itchy nose, sneezing, stuffy sinus, and itchy throat.

He is here to follow up on skin testing today and he was unable to discontinue his Chlortab.

His skin test showed very highly positive for grasses, trees, weeds, molds, dog hair, dust mites, and cockroach. So, we further discussed that how we can help manage his symptoms. He has not tried the Flonase yet at this time. He has not picked that up yet. He just pressed out the use of not using his Chlortab. The Chlortab helps relieve most of his symptoms and he is willing to try the Flonase two sprays once daily to see if they can help reduce some of his allergic symptoms.

We discussed the possibility of long-term management with allergy immunotherapy and he is very interested in this possibility of his allergies that are so severe and is tolerating to most medications. This can also help reduce medication cost in the long run and so it can be covered by insurance quite well.

1. Allergic rhinitis.
2. Allergic conjunctivitis.
3. Heartburn, controlled.
4. History of atopic dermatitis, controlled.
5. Deviated nasal septum.

1. Start Flonase two sprays once daily in each nostril as to see if this helps with allergic rhinitis.
2. Continue Chlortab as needed to manage his symptoms.
3. Per consent of the patient and their findings with insurance, we will begin allergy immunotherapy and hopefully follow up with this patient when he begins allergen immunotherapy.


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