Well the good news is:
1. no "nose culture", because there didn't seem to be any "pus" (nice) in her nose.
But the bad news is:
1. her nasal polyps are bigger
2. one ear tube is out
3. the other ear tube is coming out.
So, therefore we should
1. add a nose inhaled steroid for a month to shrink the polyps and then follow up
2. make an appointment for allergy testing - since her last tests were done so long ago, because unresolved allergies can cause inflammation which causes polyps
3. continue everything else
In addition we should,
1. do a hearing test at our visit next month for a baseline (due to TOBI potential side effects)
2. call Jane from St. Louis for a heads up and ask her how removed "polyp material" is handled, shipped, stained, tested in the event that Elizabeth does have them removed in the future. Polyps are full of ciliated material that would be very useful to examine and then we would potentially have a definitive diagnosis.
3. hope she doesn't get an ear infection.
Other Unrelated To Do Items
1. order a genie girl costume for Halloween.
2. stop procrastinating by blogging and clean the office - nobody reads this anyway.
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