June 2, 2020
The CF doctor felt that an in person visit was needed at this point, as Azer's cough hasn't gone away. He felt like the sinus rinses improved the cough somewhat. He is unsure if adding the EES has done that much, other than possibly stopping the fevers. Azer wants to stop the EES and go back to taking the Trikafta normally, as he feels like the Trikafta isn't as effective this way.
Last week, Azer had his wisdom teeth removed, which went very well, and he recovered quickly, and he was able to do PFT's today. His lung function was really good today, for how he sounded. The doctor heard some crackling in one lung, but it moved after he coughed.
When Azer had his teeth removed, he started a high dose of ibuprofen for pain, and he said his lungs haven't burned while on it. The doctor felt like this may indicate some irritation of the chest bones, and less likely due to reflux. She said he should discontinue the ibuprofen as it is hard on the stomach and kidneys. Since his cough has improved with the steroids added to his nasal rinses, she wants him to continue with this and she is making an appointment for him to see the ENT doctor. He had a chest X-ray today, and they are running a normal CF culture, and also an additional one to test for microbacterium, just in case.
The doctor mentioned that if the fevers continued, he may need to come in for IV's, but Azer has been frustrated that they are still reaching for possibilities of what this could be. He said he's been on oral and inhaled antibiotics, oral and inhaled steroids, and neither of those have helped at all. The doctor agreed he's been coughing for too long, and that if the ENT can't find any cause, and the fevers come back, that it may be time for a bronchoscopy. She would want to do this inpatient, as usually this can lower lung function temporarily. Due to Covid-19, he would have to be tested in another portion of the hospital first, before being allowed to check in normally. Hopefully, we have answers before this becomes necessary!