Personal Narrative: My Personal Experience With Emission

I have caught up with Nicole a month since the last appointment. During that time Nicole has been quite well, although in the last week or two has noted increased nasal congestion with post-nasal drip and subsequently there has been some throat clearing and cough. She is not aware of any lower respiratory tract symptoms and systemically feels well.

A recent CT chest scan demonstrates significant improvement in the multi-focal areas of consolidation, but there does remain some changes.

Nicole has been taking Nexium on a regular basis, but having paid closer attention to her symptoms, she has noted a couple of incidences of acid reflux during the night when she has eaten shortly prior to bedtime.

Examination today revealed an oxygen saturation of 97% and chest auscultation as notable
Concerning the sino-nasal problems, she is due to see David Marty next week but given the re-emergence of symptoms, I have suggested she introduce low-dose Rhinocort 32mcg on top of the saline spray. She will also trial a non-sedating antihistamine.

Nicole has had recent allergy testing demonstrating significant sensitisation to dust mite, pollens and animal mix and less so to moulds. I note she was desensitised a number of years ago to what she believes was rye grass and dust mite with some improvement but symptoms have increased over time. She may well benefit from another round of desensitisation and I will consider referring her to an allergist pending David Marty's assessment.

Another concern is that Nicole may be aspirating during the night in the context of the gastric band. It has been a number of years since she has had a gastroscopy and I have elected to refer her to a gastroenterologist to explore this further.

At this stage, I will see Nicole again in six weeks with repeat lung function test, but she will contact me sooner if she starts to develop any lower respiratory tract