A 58 yo male with asthma and allergic rhinitis reports difficulty using his asthma inhalers and nasal spray.

He has a history of DM2, allergic rhinitis, mild asthma, severe arthritis of the hands, and a R hand weakness secondary to remote stroke.

Medications:

Nasacort (triamcinolone), Albuterol MDI, glyburide, rosiglitazone

Physical examination:

HEENT: Pale boggy turbinates with 75% obstruction of the nasal cavity
Chest: CTA (B)
Extremities: severe arthritis of both hands,

and a R hand weakness secondary to remote stroke.

A hand with arthritic changes. Image source: Cicadas, a Creative Commons license.

What would you recommend to this patient?

Read more in Treatment Devices for an Asthma and Allergic Rhinitis Patient with Arthritis and Stroke from AllergyCases.org.

Original post by noreply@blogger.com (Clinical Cases)