Notes

The patient was seen in the office for a follow up. She notes that she's been doing well and that she hasn't had to use her rescue inhaler for quite a while. She uses Singulair and Advair which have been doing well for her. She does use Ropinirole for her restless leg syndrome which she notes helps most of the time. She reports a few nights where she has problems and she's not sure if it's something she eats or something she's doing that causes it. She lad a left mastectomy in 2013 and followed up in January of this year and they told her that they only need to see her yearly. She had her regular dose flu vaccine today per request.
She notes that she can't sleep and thinks it's due to perimenopause which it likely is. We did discuss using melatonin. I said depending on her problem 3-5 mg before bedtime helps some people but most of the time with perimenopause it doesn't really do much. I did tell her that there's an extended release and that if she's one of someone who wakes up and can't go back to sleep, that release may be a better help. We also gave her the sleep hygiene sheet.
She is on Dupixent which helps her nasal polyps. She is doing well there. She saw an allergy and asthma doctor in May. She had a pap smear in April with me which was normal.