August 16, 2019

CF Clinic - Sick Visit

This year is Sophomore year!

So, the day after his clinic visit last week, Azer started to sound congested. It seemed to get worse through this week. His culture from last week came through, and the Steno wasn't present, but a rare growth of Aspergillus was there. Yesterday, he and I came down with a mild virus, which didn't cause many symptoms and seemed to only last a day. However, he ended up coughing hard all night long. He said at school, he was trying to breathe shallow so he didn't end up having a coughing fit in the middle of class. He was exhausted this morning, and sounded even worse. He emailed the clinic, and we started heading in that direction, not knowing whether they could see us in clinic or not. Luckily, they had an opening in the afternoon, which was worth waiting for.

He lost 3 pounds in one week. He has been a little more active since school started, but has been eating fairly well. He had some difficulty doing his PFT today, as he was holding back coughing. He was only a point down from last week, but several from a few weeks ago.

The doctor is still trying to determine if his cough is coming back from not being on the Ceftaz, if it's from the fungus, which may or may not be colonized, or just allergies. She listened to his lungs, heard no wheezing and said they sounded so good, that she didn't see the need to order an X-ray, and she didn't feel the need for him to be on steroids right now. She looked in his nose and saw some polyps and the evidence of a lot of post nasal drip. She wondered if since the Dupixet is helping his sinuses so much, if the inflammation going down has allowed other junk that has been stuck up there to come out. Either way, he is going to try some oral antibiotics for a few weeks to see if he starts feeling better. If he's not much better, we might start to treat the fungus. In times past, it has taken months and months to treat him for ABPA and aspergillus because they were waiting for his IGE to get lower. It is almost always high whether or not he is culturing fungus. The doctor said if we have to treat it, she will treat him until his symptoms improve.

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