today she  came for follow up 

she is  doing better 
but  she ahs cough  and sob 
ANCA  Negative 
ESR    10 
Urine analysis   no uti  mild     proteiuria 
wbc  11 
hgb   10 
plt 245
creatinine  3.4 
hba1c    6.6 
tsh   0.23 
free t3    3.5 
free  t4   1.9 

she was seen  by dr anas  and he   reasured her regarding the tsh 

plan 
alfacal   once 
calcium 600 mg ocne 
nexium  40 mg  1x1  or  x2 
clonazepam 
prporanolol   10 mg 2x2 

plan 
basilox     400 mg 
aerovent  nebulizer   1x3 
mucolit    

rtc after  one month