Patient is here for followup on how her allergy immunotherapy is going and we saw her last on 10/14/2014. She states today that she is doing well with her every four-week allergy injections. She would like to continue to use her injections because if she does miss a shot, she notices problems with her allergies recurring. She also has a history of using allergy shots when she was in high school and when she discontinues them, she had increasing complaints of allergies and therefore had to start over with the allergy immunotherapy. She would like to continue the immunotherapy at this time. She does use Allegra p.r.n. and has needed it about two times in the last few months due to outbreak of allergy symptoms. Otherwise, she has no complaints of sinus infections or other respiratory infections occurring this last year needing antibiotics and she also does not feel she needs any nasal sprays or any other allergy medication to help with her symptoms. She needs a refill on her allergy immunotherapy at this time.
1. Allergic rhinitis.
2. Allergic conjunctivitis.
1. She will continue with allergy immunotherapy every four weeks and we can continue to use it for another year and see if she feels more comfortable with discontinuing immunotherapy next year. At this time, she is not ready to discontinue and feels that it would not be beneficial for her allergy symptoms.
2. She can continue taking Allegra as needed for any breakthrough allergy symptoms.
3. We discussed her recent gallbladder removal in July. She has had some continuing diarrheal problems and has noted some intolerance to milk products as well as high sugar intake. I encouraged the use of Metamucil fiber supplements and I encouraged her to go see her gastroenterologist if this seems to become any worsening problem for her.
4. We will see her next year for an annual recheck. If she has any more complaints, she can feel free to call the office and we will see her sooner.