Cerebral aneurysm for monitoring
Migraines - on topiramate
Thank you very much for referring Sandra along for her 18-month history or cough. As you are aware, she first noticed this on holidays in Queensland in July last year. She developed a dry cough at the time without any associated infective symptoms. That dry cough has persisted since that time. It is mainly throughout the day and is mild cough which is mainly throat clearing. She does not notice issues at night. She did trial Nexium for three months due to some symptoms of GORD earlier in the year and this cleared up her symptoms of GORD but did not improve the cough. She tried Nasonex for a short time without any significant benefit. She has tried Ventolin without any benefit. She has no past history of asthma and has never been a smoker. She has no other symptoms of concern, in particular no shortness of breath, wheeze, fevers sweats or loss of weight.
She is not currently working, although she does volunteer for the CFA. She has no pets at home and has not changed anything in her home environment in the last few years. She does look after her grandchildren but does not seem to pick up their viral illnesses. They do have pet dogs and she …show more content…
She does have some mild nasal symptoms so there is the possibility of post nasal drip contibuting. As such, I have will put her on Nasonex, although I have suggested that she could stop this after three weeks if there is no benefit. Beyond that, I have discussed some strategies to reduce the throat clearing and cough and she will try to implement these. If this is not helping, I have referred her along to the Melbourne Voice Analysis Centre to have an ENT surgeon visualise her vocal cords. If there is any evidence of laryngeal hyper-sensitivity, she will discuss some strategies with the speech pathologist