Dr Tanya Williams

Respiratory Specialist
Bayview Private Hospital
81 Canyon Road
Bayview

18.10.2014

Dear Dr Williams

Re: Mr Zach Foster, DOB: 25.10.1991

I am writing to refer Mr Foster, a 22-year-old builder, whose features are consistent with
unstable asthma. Your further evaluation with a lung function test and management would
be highly appropriated.

Mr Foster has been living with asthma since the age of 3 years. He visited on 11.10.2014
when he complained of a 3-week history of exertional dyspnoea with nocturnal cough and
wheeze. For this reason, he increased inhaler Ventolin use. However, preventer inhaler
compliance was doubtful. His peak flow rate was 500 L/min. Please note, he also had
symptoms of gastroesophageal reflux disease. Therefore, compliance with the preventer
inhaler, Pulmicort was advised along with a trial of pantoprazole for GORD. In addition,
smoking cessation was counselled.

On review today, Mr Foster was found still smoking and noncompliant to Pulmocort.
Besides, the ordered CXR and FBE results were unremarkable. Thus, another 7- week
course of pantoprazole along with a further emphasis on Pulmocort use and smoking
cessation were given.

Mr. Foster is a smoker, smoker 10-20 sticks a day. He has had eczema and hayfever and is
allergic to cats. He has a positive family history of asthma related to his sister.

In view of the above, would you please assess him with a lung function test and treat
accordingly.
Should there be any queries, please do not hesitate to contact me.

Yours sincerely,
Doctor