Letters to GP

Dear Dr. Emily Carter, It was my pleasure assessing Mrs. Sarah Jones in my clinic on 1 November 2024. Diagnosis: Chronic rhinosinusitis with nasal polyps. Management: * Prescribed a course of oral corticosteroids. * Instructed on nasal saline irrigation. * Scheduled for a follow-up appointment in 4 weeks. Mrs. Jones presented today with a history of recurrent nasal congestion, facial pressure, and loss of smell for the past 6 months. She reports that symptoms have worsened over the last two weeks. She has tried over-the-counter medications with minimal relief. She denies fever, but reports occasional headaches. Past medical history includes a tonsillectomy at age 8. No other significant medical history. Medications include cetirizine 10mg daily and fluticasone propionate nasal spray, which she uses inconsistently. Social history: Mrs. Jones is a teacher, lives with her husband, and does not smoke or drink alcohol. She denies any illicit drug use. Allergies: No known drug allergies. During the consultation, the following findings were noted: Anterior rhinoscopy revealed bilateral nasal polyps. Nasal mucosa was erythematous and edematous. No purulent discharge was noted. Examination of the oropharynx was unremarkable. Neck examination was normal. No diagnostic tests were performed during this visit. Based on the above findings, I have proposed the following management plan for Mrs. Sarah Jones: I have prescribed a 10-day course of oral prednisolone 40mg daily. I have also advised her to continue with nasal saline irrigation twice daily. I have provided education on proper nasal spray technique. I have scheduled a follow-up appointment in 4 weeks to assess her response to treatment and consider further management options, including possible surgical intervention. Thank you for the opportunity to care for Sarah and for your kind referral. Yours sincerely, Electronically sighted and approved by the author prior to dispatch. Dr. Thomas Kelly MBBS, FRCS (ORL-HNS) Consultant Otorhinolaryngologist [Your contact information]