Anxiety Assessment

To: 

Re: Follow-up for nasal symptoms and decreased appetite
Seen: 2026-01-14
Referred by GP
Reason for Referral: Assessment for nasal symptoms and decreased appetite

History of Presenting Concerns:
- Patient presents with nasal congestion and decreased appetite since prior to November. Nasal symptoms have improved with prescribed nasal spray, with only mild nighttime stuffiness remaining. Appetite remains selective, with preference for fruit and sweets and avoidance of rice, meats, and most vegetables. Despite this, weight increased from 27.7 kg in early January to 29.1 kg by February 11th (gain of approximately 1.5 kg in one month). Family has increased efforts to provide a more varied and balanced diet, which may have contributed to weight gain. Patient has a history of being tall and slim, with height above average and weight around the 15th percentile.
- Anxiety/Worry Associated Symptoms: Not reported.
- Triggers: Not reported.
- Impact on daily life: Not reported.
- Previous Management: Nasal spray prescribed for nasal symptoms; family is offering more varied and balanced diet and limiting sugar intake.

Review of Systems: 
ENT: Nasal symptoms improved with nasal spray; currently only mild nighttime stuffiness.
GI/Nutrition: Persistent selective eating; prefers fruit and sweets, avoids rice, meats, and most vegetables. Weight gain of 1.5 kg over one month.

Past Medical History:
- Medications: Nasal spray as previously prescribed.
- Allergies: Not reported.

MANAGEMENT PLAN AND RECOMMENDATION:
1. Continue current dietary approach, offering nutritious and varied foods without forcing intake.
2. Maintain efforts to limit sugar and sweets.
3. Continue nasal spray as needed for nighttime nasal stuffiness.
4. Schedule follow-up in July or August to reassess growth and nutritional status.
5. Coordinator will contact family to arrange next appointment.

Follow-Up:
- Follow-up appointment to be arranged.

Thank you for involving me in the care of Ethan.

Sincerely,
J. Lin
Pediatrician