Janice has returned six weeks since the last appointment. Overall Janice is feeling better with minimal cough present. She does report some nocturnal wheeze and chest tightness and does at time note a slight constricted feeling in the throat.
As you would be aware, a recent RAST assay has demonstrated sensitisation to a number of allergens but in particular dust mite.
A couple of weeks ago Janice put in place some dust mite minimisation strategies including vigorous cleaning of her carpet and changing her doona and pillow cases and has noted an improvement is symptoms since.
Over the last week, she has stopped using a proton pump inhibitor and has not noticed any deterioration in symptoms.
Although her RAST assay is positive to …show more content…
Also in her early 30s, for around six months, can recall some asthma-like symptoms following a viral infection. Aside from that, there is no other real history of bronchospasm. Furthermore, there is no real history prior to the last few months to suggest dust mite allergy, although as Janice has correctly pointed out, it may be that over a period of time dust mite has built up in her old carpet at home and she has now crossed her threshold beyond which she is now becoming …show more content…
Concerning the bronchiectasis, I have reassured Janice that the recent blood tests do not suggest allergic bronchopulmonary aspergillosis and at this stage, no specific intervention is required. If Janice does develop an infection, she will likely require an extended course of oral antibiotics. It would be useful to obtain a sputum sample for culture and treat her with Bisolvon.
At this stage chest physiotherapy for sputum clearance training is not required, but if her symptoms become more persistent over time, this would need to be considered. It would also be important for Janice to have the flu vaccine
As you would be aware, a recent RAST assay has demonstrated sensitisation to a number of allergens but in particular dust mite.
A couple of weeks ago Janice put in place some dust mite minimisation strategies including vigorous cleaning of her carpet and changing her doona and pillow cases and has noted an improvement is symptoms since.
Over the last week, she has stopped using a proton pump inhibitor and has not noticed any deterioration in symptoms.
Although her RAST assay is positive to …show more content…
Also in her early 30s, for around six months, can recall some asthma-like symptoms following a viral infection. Aside from that, there is no other real history of bronchospasm. Furthermore, there is no real history prior to the last few months to suggest dust mite allergy, although as Janice has correctly pointed out, it may be that over a period of time dust mite has built up in her old carpet at home and she has now crossed her threshold beyond which she is now becoming …show more content…
Concerning the bronchiectasis, I have reassured Janice that the recent blood tests do not suggest allergic bronchopulmonary aspergillosis and at this stage, no specific intervention is required. If Janice does develop an infection, she will likely require an extended course of oral antibiotics. It would be useful to obtain a sputum sample for culture and treat her with Bisolvon.
At this stage chest physiotherapy for sputum clearance training is not required, but if her symptoms become more persistent over time, this would need to be considered. It would also be important for Janice to have the flu vaccine