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AD.11. Manikanta Thota - Ms Ruben Philips


Dr Dennis Silhoutte

300 Main Street


4 February 2019

Dear Dr Silhoutte

Re: Ms Ruben Philips, aged 17

Thank you for accepting Ms Ruben Philips, who has been stricken down with asthma and anxiety disorder. I am referring Ms Ruben for an urgent assessment and appropriate management.

Today, Ms Ruben presented with the complaints of dysphagia, hot flushes, starvation and insomnia. Increase in seretide dosage upto 4-5 puffs in a day has reported. Breathlessness during day timing is experienced. Therefore, prednisolone is taken. Escalated anxiety and inappropriate asthma management is noticed. Risk associated with overdose of seretide is also present.

Ms Ruben started experiencing anxiety a month a ago with associated symptoms involved headache , nausea and concentration difficulty. On 4 January, after consultation with general practioner Prozac 20 mg per day was commenced. Relaxation techniques and anxiety management was reviewed. On 28 January, Ms Ruben was reported frustrated, sobbed and insomniac. Claims regarding effectiveness of Prozac were observed. Hence, reassurance regarding action of drug was providing.

In addition, Ms Ruben is persistently taking counselling for stress and anxiety management along with asthma prevention. Thorough consultations for review of health condition have been recorded since 2018. Examination for side effects of Prozac is highly recommended. For perusal, pervious medical history and reports are attached with this letter.

Based on the aforementioned circumstances, your urgent evaluation and appropriate management towards Ms Ruben Philips health condition would be profoundly beneficial. In case you require any additional information, please do not hesitate to contact me.

Yours sincerely

School Nurse

Westend High School


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